**9. Conclusion**

to the conditions of childbirth in an institution where the logic of the natural progression of childbirth is devalued or even ignored. Physiological childbirth is on one level based on a sensitive, changing hormone cocktail in the birthing woman and baby, and is closely connected to the well-being of the woman and child. If we obstruct or hinder otherwise functioning patterns, external interference becomes a necessary replacement for the physiological dosing of oxytocin in birth care that places the woman at the centre and respectfully supports her – this becomes more likely to happen outside of an institution. In contrast to authentic midwifery [51], taking natural body responses into account is not a strength of modern obstetrics, and staff, both doctors and medicalized midwives, frequently interfere and express a sense of hurry – or even, completely inappropriately, impatience. One example from data collected in an Internet questionnaire about birth experiences in Slovenia in 2005: *"What bothered me the most was that the staff kept saying, 'Come on, ma'am, everyone else gave birth already!"* [49]. In order to understand the basic needs of women during childbirth, we need to find a gender-specific understanding and sensibility and then develop appropriate approaches. Authors who acknowledge the interconnectedness of childbirth and sexuality compare the usual conditions under which we have sex, which provide intimacy, a relaxed environment and the knowledge we are not under anyone's control, with the conditions for successful childbirth, which are exactly the same: privacy, a warm, darkened space, no control or comments on appearance or behaviour. It is clear that pressuring your partner to have an orgasm will almost certainly have the exact opposite effect; similarly, scolding and expressing disapproval of a woman and her partner for kissing while she is in labour is only going to hinder the process, as often remarked by Marsden Wagner, a medical dissident who dedicated his work to supporting the well-being

158 Sexology in Midwifery

of mothers and babies and supporting autonomous midwifery [52].

*"Put your clothes back on, will you, this is not a beach."*

Women need their individual course of pregnancy and childbirth to be respected, with the lowest possible degree of interference and forced adherence to routine; they do not wish to be told to hurry up or slow down, as corroborated by modern studies of childbirth physiology – childbirth is optimal when interference and intrusive procedures are the fewest. What is more, it has been proven that women and children benefit hugely from the presence of support networks and staff who deliberately try to be as non-intrusive as possible in order to allow the individual to relax and let the natural progress of childbirth take over. It must also be taken into account that every individual mother has her own particular way of giving birth, and she must be offered support, which includes adapting the setting. If individuals are able to relax and focus on giving birth, they will find it easier to listen to their own body, which in turn makes the midwife's job easier and more fulfilling. The degree of restrictions and expectations imposed by medical staff on women in labour, especially regarding her physical expression, is illustrated by another example from my notes of a consultation with a mother of a newborn in 2011, who bared her breasts during childbirth and was subsequently scolded by the midwife,

Ensuring privacy is one of the important aspects of a birth setting. Individual women have differing definitions of privacy. However, the feeling of one's privacy being limited definitely has no positive effects on childbirth; too many people in the delivery room, unknown person‐ nel performing care, having to disclose personal information or even undergo a physical If modern obstetrics does not rethink and expand its ethical principles, it will continue to deliver inhumane treatment to women – ignoring their needs, objectifying them, marginal‐ izing their sexuality during the birthing process, and taking their power and control over a situation where these are of the highest importance. The challenge before us is to instigate a shift towards cooperation between birthing women, midwives and doctors. Midwifery is considered a caring profession, where midwives provide care to each woman and child individually during pregnancy, childbirth and early motherhood. The core tenet of midwifery is its positioning on the side of the woman; today, midwifery is undergoing modernization and it is therefore vital to recall what we have learned about the medicali‐ zation of female sexuality. Having reviewed the discourse and practices in which many midwives in institutions participate and perpetuate, we must call for more awareness about the midwife principle in modern society. We cannot ignore the question of midwives' (dis-)comfort with female sexuality, and the importance of understanding this as well as the connections with procreation capacities. Physiology and culture, which permeate every woman, her personal history and family traditions, continuously fluctuate and seek balance. Are we, as women, sufficiently self-aware that we know what we and our counterparts need in order to be able to say yes or no with a degree of responsibility to ourselves and others during childbirth, as in intimate relationships which include sexual activities?

We are still searching for answers to questions regarding, for example, the price women pay for (a semblance of) reproductive freedom. What has liberation won for us or taken away as regards sexuality? Why do women partake in this? How do women fight back? Is there a way of moving past the medicalization of women's physiological sexual and procreative processes that we can embrace now and in the future? We all have to ask ourselves how to exist in a woman's body; we must be brave in taking on questions, empowering each other and working together to create opportunities to make our personal freedom a reality. To carry out decisions, to use our brain and not let others decide about important aspects for us. To stop definitions from limiting us. To dare to see, think and know in order to live well and work well, and, most importantly, to do good.
