The concept of “orgasmic birth” first received mainstream attention in the U.S. in January 2009, when the documentary Orgasmic Birth: The Best-Kept Secret aired in primetime on 20/20, prompting, presumably, some living room spit takes. The maternity ward application of decades-old research on masturbation as a natural painkiller — the release of oxytocin potentially soothes contractions and moves things along — shocked some and intrigued others enough that orgasmic birth seems, based on press coverage (finding numbers on this is impossible), to have had a brief moment. Now, the idea of climactic or pleasurable delivery seems to be gaining traction again. Women’s Day and Vice recently profiled Angela Gallo, an Australian doula, masturbating through her birth, and Fox News covered the “new” idea as well. It’s a sexy topic made sexier, perhaps, by the frank joy with which believers are happy to discuss their experiences and recommendations on camera.
“I often recommend sex and masturbation before and during childbirth. Sex is safe in pregnancy right up until your water breaks,” Sarah Winward, a Toronto-based doula, says, noting that after the water breaks, sex or internal masturbation is not advisable, due to an increased risk of infection. “Clitoral stimulation is safe throughout labor and birth as it does not involve inserting anything into the vagina.”
Still, the science of orgasmic birth is murky at best. Although many midwives and doulas like Winward suggest sex and masturbation help move the process along, one 2012 Malaysian study found that it didn’t make much of a difference either way. And some experts believe that clitoral stimulation to induce labor can actually pose health risks. Though there is not a massive body of research on orgasmic birth, it’s already clear that sexual pleasure and childbirth are entwined in complicated ways (which isn’t exactly news to anyone who has had either sex or a child).
Evidence for or against getting off in the delivery room remains largely anecdotal and so the discussion about the medical merits and demerits of this approach is typified by comment board discourse. “I’ve had sex during early labor..but I didn’t know I was in labor yet so I guess that counts,” one mother recently commented on Baby Center. “Doesn’t seem beautiful to me when I’m in pain and a child is coming out of my vagina. Lol,” wrote another. As much as women are divided on whether to pleasure themselves or have sex, there’s one point of consensus among almost everyone: They only want to do it in the privacy of their own home.
Winward blames the understandable impulse to keep masturbation private for orgasmic birth not becoming a norm in hospitals. Medical professionals don’t exactly disagree. There’s too much of a liability risk for doctors to to recommend something so seemingly sexual (or actual sex), Barry Komisaruk, a professor at Rutgers University who’s studied the topic, explains. The American Congress of Obstetricians and Gynecologists tacitly agreed, telling Fatherly they had no comment on the matter.
But Komisaruk is quick to point out that there are other, more serious concerns that prevent doctors from suggesting masturbation or even sex instead of a spinal block. Specifically, he argues that the research only supports that vaginal stimulation dulls pain and stimulates contractions through oxytocin secretion, not clitoral stimulation. The difference between the two is the difference between internal and external masturbation and stimulating two entirely separate sensory nerves — the pelvic nerve in the vagina, versus the pudendal nerve in the clitoris. Clitoral stimulation could cause these effects tangentially, but only if a woman has an orgasm, which is probably unlikely in the throws of labor. The research does not indicate that clitoral stimulation in itself with yield the same effects.
“Clitoral stimulation itself does not produce pain blockage, and as far as I know it doesn’t promote oxytocin release,” Komisaruk.
The bigger concern is that if it did promote oxytocin release, that might be bad news for women. Oxytocin can be instrumental in advancing labor once it starts and even effectively induce labor. If women masturbate or have intercourse and stir up the oxytocin produced in nerve cells in the brain and stored in the pituitary gland, they risk running out and it takes hours to replenish the stuff. By using up oxytocin reserves needed to move labor along, women could put themselves at risk for more difficult deliveries.
“I think that would be a very bad idea to do vaginal massage to induce labor,” Komisaruk warns.
With sex especially, there’s always a risk of this inducing on accident because sex is fun. Not to worry, it just may be another reason to hold off on masturbating on top of that, in order to let oxytocin reserves build back up.
The main reason women would even want to consider this is because childbirth is painful that women are willing to try anything to alleviate that, even if it is a little creepy. The data, though limited, does that show vaginal massage can increase a woman’s pain tolerance by up to 100 percent, Komisaruk says. Though epidurals are also a common and effective way to treat pain utilized by 61 percent of pregnant women, the science is somewhat conflicted on pros and cons of drugs. Some studies suggest that they increase the risk for c-section, while other studies challenge this. Research similarly shows that they can slow labor down, and speed it up. Anesthesia can potentially increase the need to use antibiotics, which isn’t ideal, but not uncommon or dangerous. While there’s some evidence that vaginal massage through sex or masturbation may help, that doesn’t mean taking a less arousing approach will harm a mother or her baby.
“I don’t think there is a downside of not doing it per say,” Winward says. “The downside is that a lot of people don’t realize that it’s a helpful option or don’t feel comfortable enough in their birth environment to use it.”
What may be happening leading to the return of interest in orgasmic birth — and, unfortunately, this is a theory based on documented sentiment, not analyzed date — is that mothers dissatisfied with the hospital experiences are opening themselves up to new ideas, specifically within the confines of their own homes. Still, the reality is that exciting fringe practices always get an outsized amount of press. Most women give birth in hospitals and many women give birth in hospitals having never heard of orgasmic birth or actively considered the idea of rubbing a kid out. Orgasmic birth will not become common, much less standard, until it receives support from doctors, who defer, quite rightly, to the latest research. Without better evidence, advocates of sexy delivery will remain an appealingly vocal minority. And that might be for the best.