
I wanted to draw attention to a strange myopia that affects many people who comment on the Buddha’s teachings about suffering.
In the four noble truths, the first truth is that of suffering (dukkha), and it’s described in the following manner:
Suffering, as a noble truth, is this: Birth is suffering, aging is suffering, sickness is suffering, death is suffering, sorrow and lamentation, pain, grief and despair are suffering; association with the disliked is suffering, separation from the loved is suffering, not to get what one wants is suffering — in short, suffering is the five categories of clinging objects.
Here the Buddha lists a number of occasions for suffering that arise in life. Some, like birth and death, don’t happen in our lives very often. Others, like sickness, are quite frequent. Some, like separation from what we like and being in the presence of things we don’t like take place multiple times in the course even of just one day.
The first instance of suffering that the Buddha gives is birth. It’s a natural place to start, perhaps.
What I find curious is that many, many writers on Buddhism interpret “birth is suffering” solely in terms of “being born is suffering.” This is a long-standing tradition. Fifteen hundred years ago, or so, Buddhaghosa, in his treatise, “The Path of Purification,” listed several ways in which birth is painful. He tells us it’s painful:
- to be confined in a womb
- to be physically jarred in the womb when your mother moves around
- if your mother has a miscarriage
- to be forced through the birth canal
- to have your sensitive skin touched after you’ve been born
You’ll notice that this is all focused on the one being born.
Was your birth painful? I don’t know about you, but I can’t remember. Presumably it was traumatic at the time, but my brain wasn’t developed enough to commit the details to memory.
Now, would your mother say that birth was painful? Probably! She experienced much more pain than anyone else involved. Was it psychologically painful for her? Probably. It’s a worrying thing to give birth.
Was it painful for your father? Not physically, but he was probably anxious about the health of your and your mother.
Lots of other people were probably anxious too, and relieved when you were born, hopefully healthily.
The Buddha was of course born at a time and place where birth was much more dangerous than it is for most of us reading these words. His own mother is supposed to have died not long after he was born, presumably from complications of childbirth. In many parts of the world, death during or just after childbirth is still common. In fact both of my adopted children’s birth-mothers died this way.

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For me, the most bizarre part of Buddhaghosa’s list is the bit about miscarriages. To consider the suffering involved in such a thing and not give any thought to the experience of the mother is just bizarre.
Buddhaghosa remains an important influence on Buddhism to this day. A lot of Buddhist teaching is essentially what I call “warmed-over Buddhaghosa.” And so his myopia becomes the myopia of contemporary Buddhist teachers — or many of them, at least. Just today I listened to a teaching on suffering by a very talented contemporary teacher who explained “birth is suffering” as “being born is suffering.”
Probably because Buddhaghosa was a man who had lived all his life in cultures where men were the focus of attention, he just didn’t give much thought to the experience of women. And he was talking to men. But even those men had mothers and sisters who gave birth, so there’s a kind of misogyny, or at least myopic gender-bias, in operation.
Part of what’s going on here is how people tend to pass on presentations of the Buddha’s teachings in much the same way they had first learned them — including the mistakes and the myopic omissions. So you learn from a book or a talk that “birth is suffering” means “it’s painful to be born,” and that lodges in your brain. And then having learned what this, you stop thinking about the subject. You don’t reflect on it. You don’t compare it to the lived experience of people around you. It’s just a “factoid” that inhabits your brain, in some way isolated from everything else you know.
This lack of reflection on what the Buddha taught bothers me. Not connecting what the Buddha taught to your own lived experience (a teacher may not have given birth, but they’ve surely heard women say how painful it is) bothers me. And of course ignoring the painful experience of half of humanity bothers me. Aren’t empathy and compassion meant to be part of the Buddhist path?
Buddhism is about suffering, and responding wisely and compassionately to suffering. And yet most of the suffering around the topic, “birth is suffering,” gets ignored. That’s kind of weird.
Similar things can be said about death, although that’s a less gendered topic. There’s a form of myopia where “death is suffering” becomes “dying is suffering.” But it’s not just dying that’s painful. It’s painful to have a loved one die. It’s painful to think that one day they will die.
There are many other ways in which Buddhist teachings are passed on from generation to generation in a habitual, unreflecting way. In another article here I tackled a few recurring myths about the Buddha’s life. I’ve written about another mistaken teaching about suffering that is commonly passed on. I could write a book full of these.
All of these repeated misconceptions weaken and dull the teaching of Buddhism. The less teachers (and their students) are able to connect Dharma teachings to their lived experience and to the experience of others, the more abstract the teachings seem. They exist as the “factoids” I mentioned, floating in the mind, untethered to our real lives.
So the next time you hear a teacher talking discussing “birth is suffering” purely in terms of the suffering a fetus and baby go through, I’d suggest that you gently bring up the topic of all the others involved in birth who suffer in more significant ways — the mother above all. It might end up changing Buddhist culture in the west.

18 Comments. Leave new
Thanks for this. I find it very enlightening that, although a woman, although I have given birth and although labour was long and difficult and, yes, painful, not once had I given any thought to this. Which goes to show how ingrained those myopic admissions can be.
It’s weird, isn’t it, how our experience and memories can be manipulated by other people’s ideas?
Suffering in this world for both people and animals is what keeps me up at night. I so appreciate everything others do to help those creatures and people but the overwhelming truth is, suffering will always exist and I still have not found a way to cope with that . It’s ever present in my mind . I am practicing gratitude and also meditation – I will try to stay disciplined with this in hopes it helps.
Hi, Peggy.
As you say, suffering always has existed and always will. This is just something we have to live with.
I’d suggest a good place to start is with self-compassion, since the difficulty we face is dealing with the suffering we face as we are aware of others’ suffering. I explain this practice in my most recent book, “This Difficult Thing of Being Human.” The feedback on the book has been very good.
Another way to cope with suffering always existing is just to keep reflecting that that’s the case, and to keep our focus more on the suffering we can personally address, rather than on the more abstract idea of the totality of suffering. The more we keep our focus on what we can actually do, the more empowered we feel. The more we focus on the totality of suffering that’s out there, the more disempowered we become.
All the best,
Bodhipaksa
Peggy, what you said resonates with me. To take this a step deeper, these Four Noble Truths may need to branch into gender specific suffering. I don’t know how it would be done. For example, menses. Yes, women would suffer more directly, but men could suffer in other ways. Nobody wants to experience a loved one doubled over, vomiting, and loosing blood. But then we get into Attachments, and Buddhas teachings about the negative effects attachments. Where does it end? How can we keep it organized?
I first started learning about Buddhism when I was 14 1/2 weeks in preterm labor with my daughter. The teaching resonated with me and made me keep my sanity. I would love to deepen my practice but do not have the funds to work with a teacher. I read often and meditate. Can you recommend some books. With living kindness
Hi, Theresa.
I don’t actually read a lot of popular books on Buddhism. I like Sharon Salzberg’s stuff, and Thich Nhat Hanh’s. I recently published a book called “A Year of Buddha’s Wisdom, which is meant to be very practical. You might find it helpful.
All the best,
Bodhipaksa
Thank you. I’ve had these same doubts since I was a teenager. To say that birth is suffering and for people to actually believe it; to me, that is programming the subconscious to end this life as quickly as possible, and probably causing more unnecessary grief along the way as your subconscious mind sabotages you along the way.
Having not read the texts you are pointing out I cannot really comment upon your criticism of them other than yes, it is a generalisation and awful myopic state that appears to be a general public consensus consciousness. However, we should not throw the baby out with the bath water. Every sentient being has been introduced to the suffering of being born, including the birth mother, who herself suffers immensely and even dies during helping another sentient being into any world. And being born what is it like? The description’s that Buddhaghosa gives above are the personal intrinsic sufferance of the sentient being, it is this that we must refer to in our practice of the untying of the conditions of suffering as it is a true event that we have personally suffered. Although our host and writer may not have the memory apparent himself he will undoubtedly carry the memory within his mindstream/nervous system and for some this trauma is apparent during many years of childhood. I would refer to the the work of Stanislav Grof and the thousands of patients who describe hallucinations of being swiftly taken from an oceanic state of oneness, be it sea, desert, forest or sky and suddenly being crushed by a machine that destroys the ‘perfect equilibrium state’ pre-birth in the womb. I myself suffered 3 recurring hallucinations 4 or 5 times a year from an early age of childhood from 2-9 that were exactly as Grof describes in his work which I found much later when I was 20 years old. The shock of this validation of the terror and then sudden illness over and over again during my physical development is relative to this discussion. As a child I had no idea why these visions would rise as a signal that I would become violently sick for a week or more. Because of Stan Grofs work in investigating the reports of his patients it turns out that there is a huge mass of people who do remember the birth trauma but also the womb oceanic mind. I vividly recall these stages because they would erupt in my mind as i was developing as a child. I guess I am writing this as a footnote to suggest that the study of the mind can bring us back to the first noble truth. And that we have the capacity to endure that memory and in fact as has been shown by Grof and many other therapists and healers it explains many later life trauma cycles. I am not in any way suggesting that the pain and suffering of the mother and father, physician and nurse are to be ignored, just that there is another way of reading Buddhaghosa in the light of later study as per Stan Grof that opens the way to understand this noble truth and experience its first manifestation. And from my experience having this knowledge has given me even more confidence in the Buddha’s teachings and that is a very good thing to have. And of course, we must always utilise the form of meditation wherein we see every other sentient being as having been our mothers! …one last thing, it has recently been discovered that black holes are actually emitting the ‘ingredients’ to form new stars. As above, so below x
(further study into pre birth consciousness can be found on youtube if you search for Stanislav Grof and also Christopher M Bache PHD who has used Grof’s protocols to go on an inner journey spanning 1979 to now and in the process went from being an agnostic seeker to a highly developed Vajrayana Practitioner. The work of those two humans is incredible, I highly recommend investigating it x Ali
(Hubble Finds a Black Hole Igniting Star Formation in a Dwarf Galaxy
Often portrayed as destructive monsters that hold light captive, black holes take on a less villainous role in the latest research from NASA’s Hubble Space Telescope. A black hole at the heart of the dwarf galaxy Henize 2-10 is creating stars rather than gobbling them up. The black hole is apparently contributing to the firestorm of new star formation taking place in the galaxy. The dwarf galaxy lies 30 million light-years away, in the southern constellation Pyxis.
A decade ago this small galaxy set off debate among astronomers as to whether dwarf galaxies were home to black holes proportional to the supermassive behemoths found in the hearts of larger galaxies. This new discovery has little Henize 2-10, containing only one-tenth the number of stars found in our Milky Way, poised to play a big part in solving the mystery of where supermassive black holes came from in the first place.)
Hi, Ali.
Thanks for sharing your thoughts.
You said we shouldn’t throw the baby out with the bath water, but I wasn’t suggesting that we should ignore any particular forms of suffering. I was only pointing out that Buddhaghosa ignores some suffering (e.g. the pain of a woman giving birth, and the grief of a woman losing a pregnancy).
Kisagotami recounts that the Buddha talked about the specific forms of suffering that women experience.
Buddhaghosa chooses to ignore this in his account of what you call the “personal intrinsic sufferance of the sentient being.” The fact is, though, that the audience Buddhaghosa had in mind when he was writing was male. He didn’t give thought to women’s suffering being included under the heading “birth is suffering” because he wasn’t going to experience pregnancy. Much of the suffering in the world was off of his radar. And the problem with that is that those attitudes are passed on, so even some women today who reflect on the truth “birth is suffering” don’t make the connection with their own suffering.
All the best,
Bodhipaksa
Pointing out the faults of others … “warmed-over Buddhaghosa.”- Thank goodness you declined to post my comment. I was going to recommend you to a family member. But really what was I thinking? When fools consort two evils collide! … thank you for shutting the gate. Ali.
Well, there’s another kind of suffering right there: the suffering of posting a comment on a blog, discovering 12 hours later that it hasn’t been published, and assuming that the blog owner is therefore your enemy.
May we all find patience. May we find peace. May we be forgiving of ourselves and each other.
Fair comments. But remember, the suffering of a mother giving birth is covered by many of the other types of suffering in Buddha’s original list. EG. “sickness is suffering,” (giving birth may cause damage/sickness, “pain, grief and despair are suffering;” “separation from the loved is suffering, not to get what one wants is suffering” .
I guess you could look at it that way. But you could apply the same logic to the forms of suffering that Buddhaghosa considers for the one being born — those presumably could also be fitted under different categories. Miscarriage, for a fetus, is a version of “death is suffering.”
The fact remains that Buddhaghosa was writing very selectively about the suffering involved in birth — that is, considering the one being born but not the one giving birth and others connected with her. He suffered from a form of cultural myopia, he embedded that myopia in his teachings, and that still affects practitioners today.
I’m not sure where to start with this! The Buddha’s teaching is complete and perfect. The Dhamma which states Birth is suffering, old age is suffering, death is suffering, is commenting on start/middle/end to human lifespan. What happens along the way, including pain is covered by the term “pain is suffering”. That includes mothers in childbirth. Those highly individuals who can remember being born and earlier lives can report with first hand knowledge to the trauma of being born. To say that the birth-is-suffering statement is “myopic” it a bit like saying “it’s painful to have a thorn in your foot” is myopic because it doesn’t also say that “it’s painful to have poison in your stomach.” The Buddha covers the pain and suffering around the birth/death/sickness of OTHERS is covered elsewhere in the list. (Grief, pain, lamentation etc).
Also, the Buddha did NOT just talk to men. He talked (and continues to talk) to all those who wish to listen and his teaching is beyond gender. To bring modern gender politics into it is ridiculous. Whatever next?! Should we accuse him of being homo/trans phobic because he does not refer to LGBT people? I suggest you get your teaching from someone who has walked the path, completed the training and become enlightened. Start with Alan James and Jacqui James or Paul Harris, all modern western enlightened beings who can be found in Wiltshire. Start with “The Unfolding of Wisdom” by Alan James.
Hi, Lucy.
“The Buddha’s teaching is complete and perfect.” None of us have heard the Buddha’s teaching. All we have access to are other people’s records of what he taught, passed down from fallible human to fallible human for the last 2,500 years, and that have been systematized, elaborated, and explained in commentarial texts. Are you seriously going to contend that no biases have affected the process of transmission of what the Buddha taught, or the attempts to systematize, elaborate, and explain what his teachings were about?
You seem to be under the misapprehension that I’ve commenting on the Buddha’s teaching that “birth is suffering.” Read the first sentence in this article. It says, “I wanted to draw attention to a strange myopia that affects many people who comment on the Buddha’s teachings about suffering.” In other words I’m talking about how people explain the Buddha’s teaching.
“Also, the Buddha did NOT just talk to men.”
Where exactly did I say that the Buddha only talked to men? If you’re going to criticize an article, I suggest focusing on what the article actually says, rather than some straw-man fantasy that you’ve conjured up.
Actually, I see why your reading of the article is so skewed. You write, “To bring modern gender politics into it is ridiculous.” I haven’t brought politics into this topic at all. I’ve pointed out that teachers like Buddhaghosa were concerned about the suffering of a fetus being miscarried, but fail to mention the suffering of the mother, father, and other family members. That’s not a political point. It’s an ethical one. The fact that you see this as a political statement is to do with your own mind, not to do with anything I wrote. Apparently you read this article through the filter of your own political views, which meant that you didn’t actually read the article at all, but saw some kind of imagined political (liberal?) bogeyman.
I suggest that if you have access to enlightened teachers, you put into practice their teachings and learn to see the world in terms of Dharma rather than your own political biases.
With metta,
Bodhipaksa
I’m loving this series, which I’ve just discovered, but not so persuaded by this one. It’s certainly possible to imagine the Buddha giving a list of specific sufferings that different groups in his audience might encounter along the lines of : it’s traumatic to give birth, it’s traumatic to have your country invaded, it’s traumatic to be attacked by an animal, it’s traumatic for all your house catches fire. That would be one way to teach about the fundamental reality of suffering. But surely the tone of the way he chooses to teach it here is rather to impress on everyone the shared and universal sufferings that they face ? Since the function of the subsequent items is to demonstrate that no matter who is listening or what their circumstances are, they are all going to suffer in all of these ways on the the list, it would seem quite strange to begin this teaching by saying: “but first I want to single out just one separate type of suffering experienced only to those of you who give birth”. So my vote is that it’s more likely on that basis that he points to the traumatic experience of being born. I’ve never seen a baby who enjoys it!
Surely I don’t focus exclusively on mothers here, and instead point out that birth is a time of pain for fathers and other family members as well — the baby included. Birth is generally a time of stress and fear, and would have been more so in the Buddha’s time.
My purpose was not to argue that a more expansive understanding of “birth is suffering” is what the Buddha really taught. He almost certainly did mean that being born was painful for the baby, although elsewhere he acknowledged that birth is a time of suffering for women.
I’m really making the point that teachers often discuss and pass on these teachings disconnected from the realities of life, and that if we look more deeply at the ways in which birth is suffering — not just for the baby but for others as well — then we see the reality and all-pervasiveness of suffering more clearly. We see a whole constellation of different forms of pain round about the act of being born. Some of them are pains we might not suffer directly ourselves. Some of them are. But in contemplating these things we have more opportunities to be empathetic.
Anyway, in talking about birth being a form of suffering, why exactly would it be strange to include sufferings that affect some people more directly than others? If I, as a man, were to see a woman giving birth, in pain, to a baby that is also in pain, then I too will experience pain. I may not experience the physical pain of being born or of giving birth, but it affects me emotionally, through things like anxiety or a sense of helplessness. Birth is painful.
As a kind of aside, I find it moving to take each instance of suffering that Kisāgotamī outlines in this poem:
‘Being a woman is difficult,’
declared the trainer of those who can be trained.
Sharing the same husband is also suffering,
and for some even giving birth only once.
There are well-bred women who drink poisons,
and some who cut their husbands’ throat.
Having become murderers,
they all experience misfortune.
I was on my way to give birth,
when my husband died.
I gave birth on the street,
far from my own house.
My two children have died,
and on the roadside lies my dead husband: I am miserable!
Mother, father, and brother,
all burnt on one funeral pyre.”
“Poor you, without a family,
you have been through a lot of suffering,
shedding tears
for thousands of lives.”
“I lived in the middle of the cemetery,
right by my child’s half-eaten flesh.
With family destroyed, blamed by all,
a widow, I found the deathless.”
Just pause with each line and imagine it. It’s a very powerful thing to contemplate the depths of suffering she’s talking about — and in talking about the suffering of birth it’s not just the pain of the physical act, but of knowing that she’s now alone and has no one to support her and her baby (or she had two children and they died). It’s a powerful passage precisely because she’s not just making general statements about this or that being a source of suffering, but because she’s showing you what that actually means in practice.