The Biological Economy of Birth

It is the intention of this paper to ask a number of questions regarding the biological economy of birth, to bring together as much evidence as possible bearing on the answers, and to indicate certain lines of research emanating from them. In what way does the process of birth subserve the new individual, and through him the race? It is my belief that it exerts definite influences on the future psychic and physical patterns of the child, especially on these larger patterns of the distribution of energy and the intensity of drives rather than on the specific smaller patterns that characterize one neurosis or another. These influences are accomplished, I believe, mainly by the degree and shape of the organization of antenatal narcissism to meet postnatal needs, such organization resulting largely from the process of birth.

This paper concerns itself with normal birth—whatever that is. It is much easier to establish criteria for definitely abnormal births than to define normal birth. In fact some obstetricians will question whether human birth among civilized people is ever normal; and pregnancy has been defined by one as a disease of nine months' duration.

The lines of inquiry are as follows: the general implications of pain; the question of painful birth from the child's rather than from the mother's angle; an examination of the sensory-motor balance of stimulation and response possible in the infant just before, during and after birth; the possible relation of this sensory-motor ratio to patterns of normal tension potential established at birth; and finally the effect of such patterns on the primary narcissism of the infant and on the energy distribution.