The Clitoris in Labour

Did you know that, like an iceberg, most of the clitoris is hidden beneath the surface? I didn’t until a couple of years ago but there was a spate of pretty pink 3D clitorises (?sp ??clitorati) on the net and it got me thinking and Googling.  I found an article by a urologist who kept failing a test because her answers didn’t match that given by the textbooks. Helen O’Connell’s paper in the Journal of Urology (2005) was a real eye opener, a mine of information on the anatomy of the clitoris – and the history of that anatomy which shows that sometimes the textbooks are just plain wrong.

According to Wikipedia (I know … but practically everyone else agrees) the function of the clitoris is to provide women with sexual pleasure. All well and good and thanks very much, but any structure that lies anywhere near the birth canal must be a candidate for a role in birth. Birth is the evolutionary bottleneck which must surely trump women’s pleasure – and, when all’s said and done, most of the time the clitoris doesn’t even provide a woman with an orgasm in the standard human mating position!

When we started to walk upright four million years ago, the standard mammalian mating position, the male entering from behind, became problematic. (Read Elaine Morgan, The Descent of Woman for more details) The practicalities of a vagina that was becoming inaccessible switched the mating position to face to face, but the clitoris was on the wrong side of the vagina to be stimulated with any ease during sex. Besides, the male had ‘lost’ his penis bone and with it the means to provide adequate stimulation (sorry chaps). These days the happy pair are indeed fortunate if he manages to hit the G spot with any accuracy and with any regularity (or perhaps I have just been unlucky).

The trouble with those pretty pink models of the clitoris is that they march across the page with no indication of quite where they are situated. Call it my inadequate female brain if you like, but an ability to manipulate 3D structures in space is not my best attribute. I struggled to sort out in my head where all those extensions and extremities fitted in (the outside button bit was the only bit I was sure about). I got there in the end.  It turns out that the two legs (crura) are attached each side of the pubic arch and the two bulbs project backwards either side of the vagina where they seem to be known as the vestibular bulbs. What might be called the main body of the clitoris lies behind the cartilage of the pubic symphysis. A portion of this root doubles back on itself and burrows through to the Mons of Venus at the apex of the pubic arch. The glans, the visible ‘button’, is at the end of this root. The legendary G spot now has an anatomical explanation, it corresponds to the corpus, the root of the clitoris, which is higher up behind the symphysis pubis. The nerves of the clitoris are huge, visible to the naked eye, and travel back to the sacrum.  So now you know.

In my book, Dynamic Positions in Birth, (Pinter and Martin, 2014) I had speculated that the G spot might be stimulated by the back of the baby’s head on the journey down the birth canal and that this could be responsible for triggering Ferguson’s reflex. Ferguson’s reflex is a nervous signal to the hypothalamus which results in a bolus of oxytocin giving the uterus a tonic contraction which assists the mother in the final pushes for the baby to be born. (More than assist – a large enough uterine contraction can do practically all the work.) Now that I knew that the G spot was part of a larger structure, everything dropped into place. (Confusion about its location is now explained, because it is stimulated at one remove through the vaginal wall and it is not so much as a spot as an area.)

Birth should be orgasmic, the fluttering vaginal contractions of orgasm initiated by the downward movement of the fetal head also ease the baby out.  The engorgement of the vestibular bulbs and the crura cushion the back of the baby’s head from the hard bones of the pubic arch. Vaginal orgasm at birth is the intended target of evolution. Orgasm by external stimulation during sex is an added bonus. (It says a lot for our birth culture that it is so rare … yes, me neither.) It probably says even more for our birth culture that textbook physiology has absolutely nothing to say on the subject. I wonder whether all that engorgement and lubrication protects women against tearing?

In Spiritual Midwifery Ina May Gaskin makes much of what partners can do to help their women give birth – loving, smooching, cuddling and sexual stimulation.  Though it grieves me to say it, there are some obstetricians who stimulate the external clitoris mechanically to ease birth, which seems to me to be a gross intrusion, verging on assault. They do at least have physiology on their side – like nipple stimulation, it releases oxytocin,  but both orgasm and oxytocin secretion are shy phenomena, failing to manifest themselves in stressful environments.

A role for the clitoris in labour would make sense of many of the things we see in birth. We might find that birth proceeds better when we adopt positions where maximal clitoral stimulation is possible, not just upright, but forward leaning, acknowledging our quadrupedal heritage. It would certainly proceed better in the same sorts of environments that facilitate sex. Anyone for sex in the lithotomy position gazed on by a posse of strangers (me neither)?

 

8 thoughts on “The Clitoris in Labour

  1. I first read about the shape of the clitoris in Cut, the book about FGM by an amazing woman whose name annoyingly escapes me….. Hibo Wardere I think her name is spelled! She said how a surgeon surgically reconstructing women as much as she can to aid normal function realised that the clitoris is largely untouched because the majority is below the surface. I can imagine it, in a very smart 3D visual kind of way not actual anatomy way. Thank you for more info to make me realise how amazing bodies are!

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    1. Thanks. The more I think oabout it the more I wonder why no one has thought of it before – but science is based on the male body and sees female parts only in relation to their own concerns perhaps.

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  2. I have first hand experience of this and I believe you are totally correct! . Please feel free to try and contact me via fb if you want to chat more. I’m in a few home.birtj and natural birth groups. Located in the UK.
    (I’m not a weirdo. I promise lol!)

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    1. Hi Katy, I’m not a weirdo either! Thanks for your comment. Glad it rings true for you. Lovely to have confirmation. I can hardly believe that no ‘establishment’ researcher has noticed this before, but so much anatomy and physiology is andocentric – and it suits the establishment to have us immobilised on the bed for birth.

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  3. So interesting, thank you for this article! I have no experience from childbirth myself, but it just makes so much sense, all of it. And I see the parallel from years of searching for help for my menstrual pains, and how little the gynecologists I met had to offer on this (except for always, always suggesting taking hormones as the “solution”). Only through talks and exchanges with other people, outside of the “textbook” thinking, have I been able to find healthier ways forward – for example by simply allowing my body to rest when it clearly needs to – and by that I mean, resting for 2-3 days a month whenever possible. To many people this sounds “extreme” because we’re so not used to “having to” (or “being allowed to”) follow our bodies’ needs (until we REALLY have to when getting sick), which when you think about it is just totally upside down, isn’t it? Maybe a little off topic but still feels like situations risen from the same “worldviews”. Thank you for spreading this knowledge!

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    1. I’d always assuemd doctors knew how bodies work – but the female body remains a mystery and it seems to be up to us women to decode! (after all, we are in a better position to do this) Regarding menstrual pains, my grandmother told me she spent 2 days in bed each month for this and I know my sister would have liked to. I was lucky, just the forewarning of a bit of backache. You might have seen this already, Jenny, but take a look at this: Sophie Messager made this video https://www.youtube.com/watch?v=QyAtqtqvgHQ&t=1s

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  4. Rubbing a woman’s clitoris for any reason without their consent is assault, not verging on it. It also goes for providers and nurses who put their thumb over the clitoris during a vaginal exam.

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