Why is birth dukkha?

Stock descriptions of dukkha often state that “birth is dukkha,” along with things like sickness, age, death etc; however, it seems less than self-evident that the process of being born would be unpleasant as I’m not sure if a newborn is even cognizant enough yet to have some awareness of what is happening to them. Any insights?

See, e.g., from the first sermon (Sujato, my bold):

“Now this, bhikkhus, is the noble truth of suffering: birth is suffering, aging is suffering, illness is suffering, death is suffering; union with what is displeasing is suffering; separation from what is pleasing is suffering; not to get what one wants is suffering; in brief, the five aggregates subject to clinging are suffering.

Some time in the past we were born. Now, birth (jāti), has
special meanings from a Buddhist point of view. Generally
it refers to parturition but when the Buddha says that “birth
is dukkha,“ He refers to the whole period from conception
to extrusion from the womb. The whole process of nine
months or so is continuous experience of dukkha.
Some people are under the impression that the womb is a
cosy little home where a being is well sheltered and
comfortable; even that it is a place to which we desire in life
to return as a retreat from problems and difficulties. But
Buddhist texts give a very different picture. The classic
description is in “The Path of Purification,“ Ch. XVI paras.
37–40, where the womb is pictured as anything but pleasant.
As Venerable Buddhaghosa Thera says: “ … when this
being is born in the mother’s womb, he is not born inside a
blue, red or white lotus, etc. … ” but surrounded by all the
unattractive collection of tubes and lumpish organs with
which the skin is stuffed. Even then there are more
attractive parts of the body than the belly where digestion
and excretion are also taking place.
The womb might be considered a pleasant place if the being
to be born had never lived before. If, as western religion
theorises, a man begins life in the womb with the soul
implanted there by God and the material inheritance from
parents as the only causes, or as western psychology
assumes that the material inheritance alone is sufficient
cause, then the womb might seem bearable. But none of
such views will suit a Buddhist. We understand that beings
are reborn in accordance with their past kamma. Now, take
the case of a man, intelligent and cultured, who suddenly
dies and whose mental continuum guided by past kamma
takes “birth,” is conceived in a womb. If memories of the
past life persist, as seems to be the case at least sometimes,
how cramped will seem the tiny prison into which he has
put himself! How helpless he will feel! If we consider the
case of a being born from one of the realms of existence
purer than the human world then how much worse will
seem his predicament. Accustomed for ages to a subtle
body, radiance, the convenience of immediate travel upon
thought, purity and pleasant sense-experience, how will a
former deva feel upon being confined to gross flesh,
darkness, inability to move, impurity and painful
After nine months (Buddhist works usually speak of ten)
imprisonment during which “he undergoes excessive
suffering being cooked like a pudding in a bag by the heat
produced in the mother’s womb,”, escape comes and the
baby is ejected into the world. Never comfortable for the
mother, the time of parturition is agonising for the child, as
Ācariya Buddhaghosa again says, “that most fearful passage
from the womb, like an infernal chasm, and lugged out
through the extremely narrow mouth of the womb, like an
elephant through a keyhole …”
When newly born it is not surprising that the first sounds
made by the baby are cries of pain. Newborn children are
not seen to laugh or even smile, something which they learn
to do much more slowly but they are very ready to wail—
and with good reason too. “The Path of Purification” notes
that “The pain that arises in him after he is born, and his
body which is as delicate as a tender wound, is taken into
the hands, bathed, washed, rubbed with cloths, etc., and
which pain is like being pricked with needle points and
gashed with razor blades—this is the suffering rooted in
venturing outside the mother’s womb.” To this must be
added these days the doctor’s or midwife’s slap (to ensure
inspiration) as further introduction to this painful world. So
it is not surprising that babies cry, especially if we think
about it in the clear light of dhamma, for in being born
inevitably they must suffer all the rest of the formula which
just begins with “Birth is dukkha.” Of course, not all suffer
in the same ways or in the same proportions. But it is certain
that wherever one gets birth, some kinds of suffering are
sure to follow. As men, we must count ourselves fortunate
(by having made good kamma) to have been born in a
sphere which is called a “good born” (sugati) where there is,
or can be, a fair amount of happiness.
Everyone forgets being born—the memory of course is
quickly overlaid—but then no one wishes to remember it. It
is an event too painful physically and too distressing
mentally, altogether too much fraught with dukkha.

From - page 11, The Three Basic Facts of Existence - II - Dukkha (Wheel publications)


A good question. I don’t think birth is dukkha in the same way that aging and death are dukkha, since we’re not aware of it happening, and have no memory of it.
I assume birth is dukkha because we have no control over it, and because it inevitably leads to aging and death.


It also might be that the fact that birth itself is when a person is reborn into another life; a life of all manner of dukkha, sickness, old age and death, that which the entire teaching of the Buddha is about putting and end to.


Keep in mind that attachment to anything that is conditioned is considered dukkha. Birth is a result of clinging/attachment (upadana) and becoming (bhava).

One can have a nama-rupa without attachment, in which case there is no further becoming and therefore birth.

But even if someone is fully enlightened, there will always be the first arrow of physical pain as long as one is alive, and so physical birth is that bondage to the physical plane.

Yes, and in DO birth is the condition for aging, death, and the whole “mass of suffering”.
Though presumably aging and death are no longer dukkha for the Arahant, who has ceased to regard the body as “me” and “mine”, and is therefore freed from the view of “my aging”, or “my death”.

But is the first arrow (bodily pain) still dukkha for the Arahant? I’m not convinced that it is, given the Arahant has ceased to identify with the body, and has ceased to assume “my body” and “my pain”.

The Northern tradition has similar commentary about the suffering of birth.

In the topic “Specific suffering in human realm”, it is listed 8 types of human suffering. The first is “Birth”

The content is generally the same as one quoted above from Path of Purification

Personally I am not convinced about being confined in closed space for 9 months is suffering.
But I agree that having to get out through very narrow passage seems very uncomfortable, and painful.

They would still feel pain and find it unpleasant. The Buddha still disliked noise and disorderly crowded areas. He also disliked it when people didn’t understand his teaching, that’s one of the reasons he didn’t want to be a Samma Sambuddha until Brahma begged him.

So being an Arahant doesn’t make them non-sentient. It just means they no longer crave anything and don’t have discontent/boredom as a result. The body is still a burden that has to be dealt with, it’s one of the reasons jhana and nirodha samapatti are attractive because it handles the negative aspects of experience, such as relief from a feeling machine (body).

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The actual process of birth might well be traumatic, but I’ve never heard of anyone actually remembering the experience.

It depends on how one understands dukkha, and the cessation of dukkha.
Bodily pain is included in the list of examples of dukkha in the First Noble Truth, but arguing this continues for the Arahant when other examples of dukkha cease appears incoherent to me, even arbitrary.

The First Truth summarises dukkha as the five aggregates subject to clinging. But note the distinction between aggregates and clinging aggregates in SN22.48.
This presumably means that when clinging ceases so does dukkha, since only “non-clinging” aggregates remain for the Arahant.

I read an article about a very desperate man who suffered very much from anxiety and compulsive disorder. He suffered so much that he wanted euthanasia. He was offered a last alternative treatment, deep brain stimulation. With this technique a kind of electrode or brain stimulator is placed in a certain region of the brain and one can stimulate parts with that ‘machinery’.

What happened? He was almost immediately cured. It was just gone. No axiety anymore, no compulsive tendencies and behaviour anymore. Bizarre, right?

Is anxiety and compulsiveness and all the feelings that accomponies this now mind-made or bodily?

Anyway, bodily pain is called unpleasant feeling but is also mental, dukkha vedana’s. It is only called bodily, i belief, because it relates to some affliction of the body. But isn’t this true for all kinds of disorders and mental suffering too? Is depression not also a kind of affliction of the body (brain) and anxiety etc? If one has a very intense experience, a kind of trauma, that also affects to body. Maybe ones behaviour changes and one suffers. Is this bodily or mind made pain?

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I think the point of the Arrow Sutta is that much of our suffering is “mental”, or mind-made.
So for example, aging, disease and death are just natural bodily processes, and it’s our response to them that causes us to suffer. If we could really accept these things, we wouldn’t suffer.


Three types of Suffering - Discussion - Discuss & Discover (suttacentral.net)

Anyway, first arrow is still there for living arahants.

I don’t think the first arrow is dukkha for the Arahant, and have explained my reasoning.
I don’t see why bodily pain would be dukkha if the Arahant no longer identifies with the body, or has the view “my body”.
And I don’t see why bodily pain is arbitrarily assumed to still be dukkha for the Arahant, when the other types of dukkha have ceased.

Anyone born gets older, and the Buddha seems to teach that such an sich is suffering. I also question this. Does this not show there is an ego? Ego does not want to get old and feel the limitations of getting old. It has always some emotional relation to what it experiences. Like, dislike. But what if there is no ego? I also think that old age, then, is just a natural process. Not suffering.

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As mentioned, it depends on the definition of dukkha.

You’re using it as only second arrow is dukkha.

Whereas by the definition in first noble truth, rebirth, old age, sickness, death are also dukkha. Arahants still undergo old age, sickness, death. So logical deduction.

Don’t try to see it via any intuition of what’s it’s like being arahant. Just see the above as logical steps.

F is Y, A experiences F, therefore A experiences Y.

This is the view from conventional truth perspective, outsider’s perspective. Not an internal perspective.

We went to a devotee’s house one day for she’s close to death, bed bound etc. Had done lots of good etc. On the way back, the driver commented that she done so much good, still suffer like that. She was mentally happy to see monks visiting her. It’s just that she still does have bed sores due to being bed bound, weak etc. I replied that these are not due to her doing good or not, it’s due to being born. Being reborn, one is subject to suffering from old age, sickness and death. Whatever the mental state it is, there’s still the physical stuffs.

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Sorry, but I don’t think your arguments are logical at all.
Why arbitrarily decide that some aspects of dukkha cease for the Arahant, while others don’t? The Second and Third Truths say that dukkha ceases when tanha ceases, and tanha has ceased for the Arahant.

And why would aging and death still be dukkha for somebody without self-view, somebody who no longer thinks of the body as “me” and “mine”, somebody with no aversion to these natural processes? It doesn’t make sense.

Well, Martin, if what you’re saying were true then why would the Buddha have back pain and lie down as a result of it?

Btw, this why Buddhadasa followers only believe dependent origination refers to the birth of an ego, and not a physical being. (Not saying they’re right/wrong, just interesting)

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Oke, but then we describe “the arahant” or Tathahata as being the same as rupa, vedana, sanna, sankhara and vinnana, but do the texts not teach one may not see any of khandha’s as the Tathagata and vice versa?

Does a Tathagata or arahant really get old or are we then talking about something the arahant and Tahtagata is not, such as the body?

Personally i feel i do not get older. I do not change at all. Oke the body gets old but i do not feel i get old. Oke, feelings change during a day or even during seconds, but do you change in the same tempo. I do not feel that, i do not thik anyone feels that way.