The Pleasure-Forward Model of Birth

In this chapter, I propose that pleasure is a symptom of birth going well, a salutogenic signal that reinforces birth physiology. I present the “Pleasure-Forward Model of Birth,” which is a preliminary framework for implementing and building on the findings of the research that I’ve presented in the preceding chapters. At the center of this model is the birthing person’s experience, and around and permeating the birth space are the relational, contextual, and structural spaces. In contrast with the “cascade of interventions” that has long been used to criticize the problematic and routine over-use of biomedical interventions here, I offer an alternative focus: to set about causing a cascade of positive, pleasurable experiences that can build toward and enhance birth wellbeing. Still, biomedical birth care is patterned by social and cultural power structures, and oppressive, violent practices and their drivers must be dismantled. Birth justice is the long game; a pleasure-forward stance to birth is an immediate opportunity. To that end, this chapter includes a practical tool for navigating birth mindsets and a praxis model. I conclude this book with a synthesis and a discussion of both the limitations of my study and of the opportunities that I present for further works, including practical implications for birthing people and their allies pursuing reproductive justice, and birth-giving as a radical praxis of worldmaking: making the world anew.