to measure the strength and stretchiness of materials, like rubber.

物質の強さと 伸縮性を測ります

But here, it's testing something different:

対象はゴムなど

tissue from a human cervix.

でも今 測っているのは―

The cervix is the gate between a woman's uterus and her vagina.

子宮頸部の組織です

It blocks anything,

子宮頸部は 子宮と膣の間のゲート

-like a penis, from going any further up. -[whistle blows]

ペニスの侵入を ブロックしたり

[narrator] And it stops important things in the uterus,

子宮で育つ胎児が―

like a growing fetus, from coming down too early.

早く降りてくるのを 防ぎます

Think of the uterus like a balloon.

風船にたとえると―

You blow up the balloon with air.

ジョイ･サラ･ヴィンク 産婦人科医

You have to keep the air in the uterus or the baby inside the uterus,

膨らますには空気を入れる

and that cervix is the knot that keeps the uterus closed.

つまり胎児ね

As an engineer, what's really struck me about the cervix

子宮頸部は風船の結び目

is that a pregnant specimen in the lab...

技術者として―

It just keeps stretching and stretching. It never breaks.

子宮頸部がすごいと思うのは

[narrator] Over nine months of pregnancy, the cervix gets five times stretchier.

クリスティン･ マイヤーズ　機械技術者

When it's soft like the skin on your lips, it opens up.

妊娠時のサンプルが―

And as you may know from experience

どんどん伸びて破れないこと

or from a common TV trope,

〝妊娠時の組織〞 〝非妊娠時の組織〞

that's usually when...

９ヵ月の妊娠期間中 伸縮性は５倍に

Mindy, your water just broke.

柔らかくなると ゲートが開きます

Ah! My water just broke.

それがテレビなどで よく見る―

Oh! I'm sitting here in a puddle of water.

このシーン

Uh... my water broke.

ミンディ 破水してる

Oh, that's cool. We got another one here in the fridge.

破水した

After the baby comes out,

水たまりができてる

this very compliant material has to remodel and repair itself.

破水した

I don't know of any other engineering material

大丈夫 冷蔵庫にもっとある

that can soften or remodel itself that quickly.

出産後は―

[narrator] Put simply,

勝手に治癒して 性質を変化させる

the cervix is an anatomical and engineering miracle.

他のどんな物質も―

But that doesn't make childbirth itself any less daunting.

こんなに早く変質できない

I'm not really scared. I'm, like... Yeah, I am nervous.

つまり子宮頸部の仕組みは 人体の奇跡

[laughs] I'm completely nervous, like, but it's only

それでもお産は大変です

because this is my first kid, so I don't really know what to expect.

デイシュ･アンソニー 妊婦

[narrator] Around the world, 250 babies are born every minute.

怖くはないけど

In hospitals or at home

緊張する

with midwives, doulas, and doctors.

ドキドキするわ

Some women use drugs for the pain,

これが初産だから

some have C-sections

想像できなくて

or use other medical technology.

世界中で毎分250人の 子供が産まれています

And others don't.

病院や家庭で

[doctor] Sweetheart, show me what you got. Ready? Nice deep breath in.

助産婦や医師のケアの元

Breath. And push from your bottom. You got this.

無痛分娩や―

Two, three, four...

帝王切開など

[narrator] But childbirth still kills more than 800 women every day

技術の助けを借りたり

around the world.

借りなかったり

And one global survey found that up

さあ頑張って　息を吸って

to 30% of women rate childbirth as traumatic.

いきんで　大丈夫よ

I just remember, like, closing my eyes and going inside

２ ３ ４…

into, like, the deepest part of myself

今も世界で 毎日800人の女性が―

to just be like, "I have to get through this."

お産で亡くなります

I was, like, really traumatized for a really long time.

世界規模の調査では

[narrator] So, what makes childbirth so hard?

３割が“出産は トラウマ体験だった”と回答

And what can women do to have the easiest and safest experience?

目を閉じて 自分の心の中に入った

-[woman] You got this. -[inhales]

一番 奥まで

-[theme music playing] -[moaning]

“生き延びなきゃ”と思った

[gasps, exhales]

長い間ショックから 抜け出せなかった

[narrator 2] The contractions in true labor

なぜ お産は 困難なのでしょう

always have a definite rhythm.

少しでも楽にするには どうすれば？

[narrator 3] You may suddenly wonder

{\an8}NETFLIX オリジナルドキュメンタリー

how the baby can possibly get through that small opening.

陣痛には はっきりした リズムがあります

Don't worry, you'll stretch enough.

あの小さな隙間を 赤ん坊は通れるのか

[man] It is not only pathological knowledge

広がるから大丈夫

which makes the great obstetrician.

産科医に必要なのは 知識だけではない

It is vigilance.

緊張感だ

One that does not let you forget you have in your hands the lives of two people.

２つの命を 背負っていることを忘れるな

[narrator] Most large primates give birth in relatively similar fashion.

出産

The female carries the fetus in her womb for 30 to 40 weeks,

霊長類のお産は 似通っています

and then the baby emerges from the birth canal,

妊娠期間は30〜40週間

usually headfirst, within hours.

赤ん坊は 頭から産道を通り―

But there's one key difference:

数時間で出てきます

humans suffer a lot more.

でも大きな違いは―

It's not like a baby just falls out,

人間のお産の痛み

like some Monty Python sketch, for non-human primates.

霊長類のお産も大変よ

They do struggle, and still,

ホリー･ダンスワース 人類学者

they have a seemingly much more easy childbirth

モンティ･パイソンとは違う

than we have.

痛みを伴うわ

[narrator] Humans labor around nine hours the first time they give birth

それでも人間よりは ずっと簡単に見える

and often go much longer,

人間の初産は約９時間か―

while most chimps labor for just two hours.

それ以上

And there's one part of the struggle of childbirth

一方チンパンジーは２時間

that's harder to quantify-- the pain.

そして数値化が難しいのが―

[woman 1] It felt like the bottom half of my body was gonna explode

痛みです

and erupt goo all over the four walls of the room.

例えるなら

[woman 2] Like you're in some kind of pain blender,

下半身が爆発して…

where you're just being spun around,

ドロドロが 壁に飛び散る感じ

and you don't know what's going on. It feels like you're being ripped in two.

“痛みミキサー”の中で 回され続けて

[woman 3] Everything painted red,

最後は 体が 裂けるみたいな感じ

and there's, like, this alarm that's like... [imitates siren]

全部が赤く見えて

[woman 4] It looked like I was experiencing an exorcism.

アラームが鳴ってる

[narrator] The question of why humans have painful births comes down

エクソシストみたいだった

to anatomy and evolution.

人間のお産が辛い理由は

The theory goes like this:

体の構造と進化にあります

Humans, unlike other primates, evolved to walk on two legs,

理論はこうです

which meant pelvises became more complicated and narrow.

人間は２足歩行に 進化したため―

Our brains also evolved to be bigger than other primates',

骨盤が複雑かつ 狭くなりました

which means bigger newborn heads.

脳も他に比べて 大きく発達しました

{\an8}So chimps get to push out a small head from wide hips,

新生児の頭もそれに比例

{\an8}while we're stuck squeezing out a big baby through a narrow space.

例えばチンパンジーと比べ―

But why did it stop there?

大きな頭を 狭い隙間から 出すはめに

Why didn't we keep evolving our anatomy to make childbirth less painful?

でもなぜそこで 進化が止まり―

Well, why didn't we evolve

お産は辛いままなのか

away from painful bowel movements?

じゃあなぜ 進化の過程で―

And why didn't we evolve out of painful breakups?

陣痛は無くならなかったの？

[narrator] Natural selection doesn't care about pain,

恋人との辛い別れはどう？

just survival. And even though it hurts...

自然淘汰に痛みは無関係

[screams]

生存が大事

...we keep making babies anyway.

痛くても…

What works, works. And what's good enough is good enough.

人は子供を作ります

It's a terribly tight fit.

大事なのは 機能するかどうか

It's a painful labor. It's a long, protracted labor,

すごくキツいし 痛みも強い

but it works. It's good enough.

時間もかかる

[narrator] So, to continue the survival  of our species,

でも機能する　それで十分

women have always been stuck  with difficult childbirths.

女性は 種の保存のために―

-[doctor] Almost there. -[Daysha Anthony] How much more?

辛いお産を続けてきました

[doctor] Not much more. One push at a time.

あと少し

[narrator] The Old Testament says,

少しって？

"With painful labor, you will give birth to children,"

あと一押し

after Eve ate from the Tree of Knowledge.

旧約聖書には―

And this scroll from 12th-century Japan shows childbirth as so deadly

“痛みの中で 子を出産する”と

that it attracted evil spirits who were drawn to near-fatal events.

イブが知恵の実を 食べた後です

That's why so many cultures throughout history found ways

12世紀の日本の巻物では お産の死の匂いに―

to protect and comfort women during childbirth...

邪悪な妖怪が 惹きつけられる場面も

with rituals and the support of friends and family.

多くの文化で―

Women also tried to numb their pain

お産中の女性を 守り励ます儀式が存在します

with opium and hashish in the Mediterranean,

家族や友人のサポートも

or in ancient Greece, willow bark, which is chemically similar to aspirin.

痛みを和らげるため―

And scientists invented new tools and technologies

地中海地域では アヘンやハシシが

to help if the baby got stuck.

古代ギリシャでは

Thanks to medical progress, childbirth got less deadly over time.

柳の樹皮も使われました

And one of the biggest areas of progress

お産を助ける発明品も 開発されました

was the Caesarean section.

医療の進化により お産の危険は減っていきます

C-sections actually originated thousands of years ago.

その最たるものが―

They're referenced in almost every ancient culture,

帝王切開

and were performed to save the baby

実は その起源は 数千年前

when the mother had little or no hope of surviving labor.

多くの古代文化で―

One of the first known C-sections where the woman actually survived

実施されました

happened in South Africa in 1826,

でも母親の生存率は ほぼゼロ

performed by the British surgeon James Barry,

母親が生き延びた 最古の例の一つは―

who was actually born a female, Margaret Bulkley.

1826年の南アフリカ

But that wasn't discovered till after his death.

執刀は英国人医師の Ｊ･バリー

And around the same time, a medical missionary

ジェームズ･バリー 外科医

observed Ugandan doctors performing C-sections.

実は女性として 生まれていたことが―

He wrote about one operation where the mother and baby both survived.

死後にわかりました

There was no anesthesia,

同じ頃―

but the woman was liberally supplied with banana wine.

ウガンダでも帝王切開が 実施されていました

In the 20th century,

記録では “母子ともに助かった”と

C-sections started to consistently save women's lives.

麻酔はなく―

And then, birthing technology really started to pick up.

代わりにバナナ酒が 使われました

Scientists started using pelvic X-rays

20世紀には―

to chart the average length and rate of labor.

帝王切開で助かる女性が 増え始めました

And for women who didn't progress fast enough,

そして お産技術は どんどん進化します

they developed a new drug to artificially speed it up,

骨盤のＸ線検査により―

called pitocin, a synthetic form of oxytocin.

出産時期の予想も可能に

It's a naturally occurring hormone,

進行が遅い場合には―

but it floods a woman's body at three events in her life:

出産を促進する薬も 使われるように

orgasm, breastfeeding, and labor.

それがピトシン

Pitocin worked so well that doctors and women

合成オキシトシンです

started scheduling inductions if a woman went a week over her due date,

この天然ホルモンは―

bringing some certainty to an otherwise unpredictable event.

女性の体内で急増します

The history of medical intervention, when it comes to childbirth,

オーガズムと授乳 お産の時です

has a lot to do with the emergence of obstetrics as a medical profession.

ピトシンの登場で 計画出産が増えました

[narrator] For most of history, doctors didn't deliver babies,

予定日を一週間 過ぎると―

midwives did.

分娩誘発の日時を決めて 出産するのです

Women trained in the real world, through experience and observation.

お産の技術の進化は

{\an8}Then in the 1700s in Europe, midwives opened up schools

ウェンディ･クライン 歴史学者

{\an8}with more official training programs.

産科医という分野の確立と 関係してる

{\an8}And as waves of European immigrants

長い間 お産は 助産婦の仕事でした

came over to America in the following century,

経験で鍛えられた 女性たちです

they brought these skills with them as they settled in the northern states.

18世紀の欧州で 助産婦学校が設立され―

While in the American South, enslaved black women were forced

教育が体系化されます

to attend to the deliveries and care of white children

19世紀になると アメリカへの移民とともに―

and were torn from their own families.

その技術が伝わり 北部で定着

And they continued working as skilled midwives

一方 南部では

long after slavery ended.

奴隷の女性たちが 白人のお産を助けるため

They were often referred to as "granny midwives."

家族から引き離されました

They tended to be senior, older members of their community

そして奴隷制後は プロの助産婦に

who had themselves already given birth

“婆ばあさん助産婦”と 呼ばれた

and were viewed with respect among their community.

地域に住む出産経験のある 年長の女性たちで

[narrator] But in the 1900s,

地域社会で尊敬される 存在だった

doctors started to edge midwives out of the delivery room,

でも20世紀に入ると 医師が助産婦を追いやり―

and they made a convincing argument.

こう主張しました

Birth might look simple. It may have been going on for centuries.

お産は簡単に 見えるかもしれないけど

But in fact, it was a pathological event that requires medical intervention.

実は病理的な出来事で 医療介入が必要だと

[narrator] Like a procedure called the episiotomy.

例えば会陰えいん切開術

{\an8}During birth, it's common for a woman to tear her vaginal opening.

お産中に膣口が 裂けることがあります

{\an8}Then in the 1920s,

自然な裂傷

{\an8}doctors started proactively cutting the opening instead.

20年代 産科医たちは 事前に会陰を切るように

I think the idea was that that would... that would be easier to sew up.

会陰切開

And it turned out that giving people an episiotomy

切った方が後で縫いやすいと 思ったんでしょう

makes the tearing much worse.

エミリー･オスター 「妊娠･出産の常識 ウソ･ホント」著者

[narrator] And around that same time,

でも実は会陰切開をすると―

Western doctors also started offering new pain drugs,

裂傷は酷くなる

like one trend that emerged out of Germany called twilight sleep.

同じ頃から

It was a mixture of a heavy narcotics:

西洋の医師たちは 痛み止めを使うように

{\an8}scopolamine and morphine.

例えばドイツ発祥の―

Extremely controversial 'cause it was really dangerous.

トワイライトスリープ

Many of the women who were behind twilight sleep

内容は強力な睡眠薬である―

were involved in the suffrage movement.

スコポラミンとモルヒネ

And their argument was

〝スコポラミンと モルヒネによる麻酔〞

that women should have the right to have a painless childbirth.

危険性が高く物議を醸かもした

[narrator] But the drugs didn't actually get rid of the pain,

推進した女性たちは―

just the memory of the pain.

参政権活動家で

Women in delivery rooms thrashed violently and screamed.

女性には無痛分娩を選ぶ 権利があると主張したの

They were often hooded or placed in cage-beds while they labored.

〝無痛分娩が 平安と強さのもとに〞

The birthing experience differed enormously

〝経験者が語る〞

based on where you lived,

でも消えるのは痛みではなく

your class background and the color of your skin.

痛みの記憶でした

There is a theory that the more civilized a race or a culture is,

女性たちは分娩室で 暴れたり 叫んだり

the more difficulty the women have experiencing childbirth.

拘束着や檻状のベッドも 使われました

And so, anesthesia was also required

お産体験は 住んでいる場所や階級―

to make sure they could get through the process.

肌の色によって変わる

Working-class women, women of color,

ある説では 文明化が進んでいるほど―

immigrant women, no problem.

お産は辛いものになると 言われている

Babies could just pop out.

そういう女性のために 麻酔が必要になったと

It was the over-civilized, upper-middle-class women

労働階級や黒人の女性

that needed help.

移民は問題なし

[narrator] That stereotype lives on today,

安産で生まれる

and it's one reason black women in the UK

上流中産階級の女性には 助けが必要

are five times more likely to die in childbirth than white women.

この固定観念は消えず―

And they're three times more likely in the US,

お産10万件あたりの 妊産婦死亡数

where disparities exist even at the same income level.

英国では 黒人の妊婦死亡率は

Biggest issue, they're not being heard.

白人の５倍

When women have said, "I'm in pain,"

米国では３倍です

the understanding or stereotype of women of color,

同等の所得でも 格差は同じ

that they're not really in pain the way they are.

ニコラ･ペンバートン 産婦人科医

[narrator] So back in the 1950s,

最大の問題は 声が届かないこと

while many black women didn't get pain medication

“痛い”と言っても―

even when they needed it,

黒人女性への固定観念で 痛みが軽視される

white women started to speak out about being over-medicated.