Birth as an American Rite of Passage

Robbie Davis-Floyd

• Publisher: Routledge
• Year: 2022
• ISBN:
  9781000574289
• Edition: 1
• Topic: Medicine
• Subtopic: Gynecology, Obstetrics & Midwifery

This classic book, first published in 1992 and again in 2003, has inspired three generations of childbearing people, birth activists and researchers, and birth practitioners—midwives, doulas, nurses, and obstetricians—to take a fresh look at the "standard procedures" that are routinely used to "manage" American childbirth. It was the first book to identify these non-evidence-based obstetric interventions as rituals that enact and transmit the core values of the American technocracy, thereby answering the pressing question of why these interventions continue to be performed despite all evidence to the contrary. This third edition brings together Davis-Floyd's insights into the intense ritualization of labor and birth and the technocratic, humanistic, and holistic models of birth with new data collected in recent years.

1 Ritual and Rite

DOI: 10.4324/9781003001393-2

Noted anthropologist Edmund Leach (1976) distinguished between “rational-technical” behavior, which “produces observable results in a strictly mechanical way,” and “communicative” and “magical” behaviors, which operate symbolically and do not stand in a cause-and-effect relationship to reality. It is the overt cultural stance of the technomedical profession that obstetric procedures are determined by physiologic reality, thus qualifying as purely “rational-technical” behavior. Yet, as I will show, these “scientific” procedures more than meet the anthropological criteria for ritual behavior, and their primary functions have at least as much, if not more, to do with the culturally appropriate socialization of the birthing woman as with her “rational-technical” medical care. To help understand how obstetric procedures can be best understood as rituals, I turn now to an examination of ritual—its characteristics and its possible effects.

The Characteristics and Effects of Ritual¹

1 Much of this chapter is of course drawn from the original edition of this book, and has been amplified by the work that Charles Laughlin and I did in co-authoring both The Power of Ritual (2016) and its abridged version, Ritual: What It Is, How It Works, and Why (2022). I thank Greg Taylor, publisher of The Power of Ritual, and Charlie for their permission to draw heavily on those works in this chapter. Co-authoring those books with Charlie gave me a chance to more fully think through the cultural phenomenon of ritual, and then to present that deeper understanding herein.

In the earlier editions of this book and elsewhere, I have defined a ritual as a patterned, repetitive, and symbolic enactment of cultural—or individual—beliefs and values; when used in initiatory rites of passage, its primary purpose is transformation. The consistent performance of ritual is an integral part of every known human culture. Here I present and examine 8 major characteristics of ritual that are integral to its myriad roles in human cultural life and central to the ways in which it wields its power. These characteristics constitute an anatomy of ritual. The characteristics of ritual explicated below are integral not only to its role in hospital birth, but also to its myriad roles in other aspects of human cultural life (see also Grimes 2002, 2013, 2020). These characteristics, as derived from The Power of Ritual (Davis-Floyd and Laughlin 2016) and from its abridged version Ritual: What It Is, How It Works, and Why (Davis-Floyd and Laughlin 2022) include:

1. the use of symbols to convey a ritual’s messages;
2. a cognitive matrix (belief system) from which ritual emerges and that it enacts;
3. rhythm, repetition, and redundancy: ritual drivers;
4. the use of tools, techniques, and technologies to accomplish ritual’s multiple goals;
5. the framing of ritual performances;
6. the order and formality that separate ritual from everyday life, identifying it as ritual;
7. the sense of inviolability and inevitability that rituals can generate;
8. performance, affectivity, and intensification—the acting, stylization, and staging that often give ritual its elements of high drama, the fact that it is performed, and that it often intensifies toward a climax.

Not all rituals exhibit each of these characteristics; however, they are all salient features of ritual in general, all part of the anatomy of ritual and its capacity as a powerful communicative form. Understanding these characteristics of ritual—in other words, deconstructing its anatomy—is essential to understanding how it accomplishes its work in the world and in birth. Now I turn to a close examination of each of these 8 characteristics of ritual and of their potential effects.

Symbolism

Ritual works by sending messages to those who perform and those who receive or observe it. These messages are not presented as straightforward verbal “rational-technical” communication, but symbolically. Most simply, a symbol is an object, idea, or action that is loaded with cultural (or individual) meaning; following Geertz (1973:93), it is “any object, act, event, quality, or relation that serves as a vehicle for conception—the conception is the symbol’s meaning.”

The whole brain is involved in all brain functions, yet neurophysiologic research has demonstrated that straightforward verbal messages are mostly received by the left hemisphere of the brain, which decodes and analyzes these messages, thereby enabling the recipient to either accept or reject their content. In contrast, symbols are the appropriate vehicles for ritual’s messages because they are received by the right hemisphere of the brain, where they are interpreted as a gestalt (Luria 1966:90; Ornstein 1969, 1972; d’Aquili 1979:173–177; Lex 1979:124–130). (See Table 1.1.) In other words, instead of being intellectually analyzed, a symbol’s message will be felt in its totality through the body and the emotions.

TABLE 1.1 Left and Right Hemispheric Brain Functions*

Left hemisphere functions	Right hemisphere functions
analytic—dissects, segregates, categorizes, evaluates	synthetic—receives the gestalt, the whole
either/or logic, linear thinking	poetic, metaphoric, analogic
emphasizes differences, discontinuities	stresses similarities, relationships
works things through	creates AHA! experiences
verbal	musical, pictorial, general semantics
speech	gestures, tone of voice
temporal (watches clock)	spatial
linear	holistic
intellectual, rational	emotional
individual more likely to be conscious of its functions	individual less likely to be conscious of its functions
*Please note: This table is oversimplified, because the whole brain operates in all brain functions, yet it is still generally useful in terms of brain hemispheric predominance. It is also presented in Davis-Floyd and Laughlin 2016:34, and is reprinted here with the consent of the publisher, Greg Taylor of Daily Grail Press.

The practical result of this felt characteristic of symbols is that their messages are often received by individuals on unconscious levels; although individuals may remain unaware of their incorporation of the symbol’s message, its ultimate effect on the recipient may be extremely powerful, acting in the immediate situation to “map changed or adjusted perceptions of the possibilities inherent in a situation onto the actor’s orientation to it” (Munn 1973:593). On a more fundamental level, Munn (606) continues, “ritual symbols may be said to regulate and affirm a coherent symmetrical relationship between individual subjectivity and the objective social order.” In simpler terms, rituals work to align the belief system of the individual with that of the social group conducting the ritual.

A Cognitive Matrix

A matrix (from the Latin mater = mother), like a womb, is something from within which something else emerges. Rituals are not arbitrary; they emerge from within the belief system of a group. Each symbolic message that a given ritual sends manifests an underlying cultural or individual belief or value. Sometimes these are made explicit in ritual, but often these deep beliefs that the ritual expresses are unconsciously, rather than consciously, held. Again, ritual’s primary purpose is to symbolically enact and thereby transmit a group’s belief system into the psyches of its participants (Wallace 1966; McManus 1979b).

Because the belief system of a culture is enacted through ritual, analysis of ritual can lead directly to a profound understanding of that belief system. Analysis of the rituals of hospital birth reveals their primary cognitive matrix to be the technocratic model that forms the philosophical basis of both Western techomedicine and American society, as described in Chapter 3; recent ritual changes in hospital birth are grounded in the humanistic model of care described in Chapter 4.

Repetition, Rhythm, and Redundancy: Ritual Drivers

The wide range of rhythmic and repetitive stimuli through which rituals act on the human body and consciousness are called ritual drivers, which have distinct neurological effects. Ritual drivers can include drumming, chanting, singing, dancing, hypnotic performances, rhythmic actions, and so on (and even electronic fetal monitoring, which is certainly rhythmic and can be hypnotic; see Chapter 5) to evoke experiences intended by the designers of the ritual. For maximum effectiveness, a ritual will concentrate on sending one basic set of messages, which it will rhythmically repeat over and over again in different forms. What is repeated in ritual can include the occasion for its performance (as in a ceremony that happens every year at the same time), its content, the form into which this content is structured, or any combination of these. This redundancy enhances ritual’s efficiency in communicating whatever messages it is designed to send; as Redfield (1960:358) pointed out, the Mayan farmer who hears the shaman chant the names of the gods 20 times in one hour, several times a day, is not likely to forget them.

Rhythmicity has long been recognized by anthropologists as a key feature of transition rituals (Needham 1979). Rhythmic, repetitive stimuli affect, or drive, the central nervous systems of ritual participants, generating a high degree of limbic arousal, coordinating emotional, cognitive, and motor processes within an individual, and synchronizing these processes among the various ritual participants (d’Aquili 1979). Under proper conditions, repetitive stimuli may bring about the unusual neural state of simultaneous high discharge of both the excitation and the relaxation nervous systems in humans (normally, one or the other predominates) (Lex 1979; Gellhorn 1968, 1969, 1970; Gellhorn and Kiely 1973). Under stable social and environmental conditions, this simultaneous discharge of both nervous systems produces an intensely pleasurable, almost orgasmic sensation (indeed, both subsystems do simultaneously discharge during sexual orgasm). Under conditions of stress, the sensations so produced are more likely to be those of calm, reassurance, and a sense of control. According to ritual theorist Catherine Bell (1997), “Rituals induce acceptance, compliance, or at least forbearance with regard to any overt challenge.”

Redundancy and repetition are two of the most noticeable characteristics that hospital birth rituals, also known as “routines” or “standard procedures,” utilize to ensure that their messages will be received and remembered. Although the intensely pleasurable sensations that can result from successful rituals are not usually a key feature of hospital birth (except when the newborn baby is placed directly into the mother’s arms or onto her body), such sensations are often experienced by homebirthers, who consciously create rituals to foster group unity among themselves and their friends and helpers, as well as to honor what they perceive as the sacred nature of birth, as described in Chapter 9. In the hospital, the calming and reassuring effects of ritual are generally paramount—but only when the laboring person experiences them as such.

Ritual Tools, Techniques, and Technologies

Many tools and technologies are used in ritual performances that enable ritual to do its work in the world and in the human brain/body to achieve specific, often dramatic, effects and results in people’s lives. In addition to its other characteristics, ritual has utility and instrumentality—which means getting things done in the world, as well as providing the means to do so—via tools and technologies.

What exactly is “technology”? The term is usually reserved for material objects, their manufacture, and their uses. Beyond this commonsense notion of technology is to see technology in a more experiential, phenomenological way—to see technology as an extension of how we act in and perceive the world. Ritual techniques and technologies are often used to transform the internal lifeworld of the individual, which is usually the goal of rituals designed to heal injury, to cure “dis-ease,” or to bring about a sense of close relationship to the divine, and is also the unspoken goal of standard obstetric procedures, as I will discuss later on. Such procedures, which almost always involve some kind of techno...

Table of contents

• Cover
• Half-Title
• Series
• Title
• Copyright
• Dedication
• Contents
• List of Illustrations
• About the Author
• Author’s Note about the Cover Images
• Acknowledgments
• Preface to the Third Edition
• Introduction: Birth as a Rite of Passage
• 1 Ritual and Rite
• 2 The Stages of Matrescence: The Pregnancy/Childbirth/Postpartum Rite of Passage
• 3 The Industrial and Technocratic Models of Birth and Health Care
• 4 The Humanistic Model of Birth and Health Care
• 5 Birth Messages in the Hospital
• 6 How The Messages Are Received: The Spectrum of Response
• 7 Scars into Stars: The Reinterpretation of the Childbirth Experience
• 8 The Holistic Model of Birth and Health Care
• 9 Birth Messages at Home: Homebirth as Holistic Ideology in Action
• 10 Technocracy in Birth and Life: Some Ritual and Political Implications for the Future
• 11 Holism in Birth and Life: Some Ritual and Political Implications for the Future
• Conclusion: Birth as an American Rite of Passage
• References
• Index