To most American women, the idea having an orgasmic birth is beyond oxymoronic. Squeezing a grapefruit-size head out of one’s vagina after enduring contractions that are incomparable to even the worst menstrual cramps sounds like a particularly elaborate form of torture. Or at least that’s what we’ve been taught.

But a new study has found it’s entirely possible for a woman to scream out in climactic pleasure as her baby makes its way through the birth canal. The study, conducted by French psychologist Thierry Postel and published in the journal Sexologies, is one of the first to attempt to nail down numbers when it comes to women experiencing intense pleasure during birth. Postel reached out to 956 French midwives with an online questionnaire about orgasmic birth, and he received 109 completed surveys from midwives who had collectively assisted 206,000 births. The midwives reported 668 cases in which mothers said they’d felt “orgasmic sensations” in birth, 868 cases of mothers demonstrating signs of pleasure, and 9 mothers confirming they had full-blown orgasms.

The study bolsters anecdotal reports of orgasm that the natural-birth advocates have been discussing for decades, most recently in the 2009 documentary Orgasmic Birth: The Best-Kept Secret. Directed by childbirth educator Debra Pascali-Bonaro, the film attracted plenty of controversy after making its primetime debut on ABC’s 20/20 in January. Several weeks before, a New York Times story on the doc prompted hundreds of comments either supporting or maligning the premise of the film. “When was the last time you had an orgasm with an eight-pound, twenty-inch penis,” remarked one sassy commenter. “Orgasm during childbirth seems gross and weird,” proclaimed another

Despite its suggestive title, the documentary doesn’t just feature mothers who experienced orgasm during birth—it also explores the many ways that the process can be a source of physical pleasure, seeking to dispel the myth that childbirth is invariably a painful and traumatic experience.

“The word ‘orgasmic’ can be used to describe food or a number of experiences, but in the film we use it to describe the heightened physical and emotional response during birth that is in line with pleasure,” Pascali-Bonaro tells The Daily Beast. “One of the purposes of the film is to broaden our vocabulary on birth with words like ‘bliss,’ ‘ecstasy,’ ‘joy,’ ‘transformation.’ It’s broad enough to also include women that actually do have an orgasm, but that certainly shouldn’t be a performance standard!”

The closest that Sheila Kamara Hay, a writer and “ecstatic birth” advocate in New York City, ever came to having an orgasm during birth was with her second child, who was delivered in 2006 at a Zen center attached to St. Luke’s Roosevelt Hospital in Manhattan.

“I started to feel the pulsing of an orgasm and then was like, oh, my God, are you serious?” she says. “And then it went away. But I saw that it was possible, and I thought, why didn’t I know about this before?”

But that brief orgasmic moment didn’t compare to the all-encompassing ecstasy she felt while delivering her third child a year later.

“I’ve never been so high in my whole life,” she says, describing how she put on music during contractions and danced along to the birth’s rhythm (“It looked like I was doing a cross between belly dancing and pole dancing and some animalistic dance.”).

That’s not to say the birth was completely painless, but Kamara-Hay says she felt sensual pleasure and the strength of her body above all else.

“Locating the ecstasy in birth has to do in part with locating your relationship with fear,” she says. “We’ve been taught so much to fear it, but giving birth is a really primal experience. For a lot of women it can be scary to shut down their minds and listen to their body during those intense moments, but that’s what birth requires of you and the less you fight, the better you’ll be able to find that ecstatic experience.”

To be sure, plenty of women who have had natural births beg to differ about the ecstasy part.

“That lady is out of her mind,” said one colleague after overhearing my phone conversation with Kamara-Hay. “I had a natural birth, and it hurt like hell. It was primal and amazing in many ways, but I was on my hands and knees vomiting in the shower at one point. There was nothing orgasmic about it.”

But scientific research suggests orgasm during birth boils down to anatomy. Furthermore, stimulation of the vaginal canal in childbirth can block pain, regardless of whether that stimulation is associated with sexual pleasure.

“Pain and pleasure travel along the same neural pathways,” says Barry Komisaruk, a professor of psychology at Rutgers University who has been studying orgasms in women since 1982. One of his experiments involved using a finger-compressing mechanism on women during childbirth, finding that women became less sensitive to the experimentally induced pain during the birthing process. In other experiments, he found that orgasm increased a woman’s pain threshold by 100 percent.

“There are many different qualities of sensation that can be elicited from vaginal and cervical stimulation, and that’s why some people say giving birth is the worst pain they’ve ever felt, and others say it feels orgasmic, pleasurable, and even erotic,” says Komisaruk.

“If a woman claims she’s had an orgasm while giving birth, who are we to say she’s not telling the truth? That’s like telling a woman in pain she’s not really in pain.”

America’s puritanical roots have influenced our culture’s relatively sterile attitude toward childbirth and even breast-feeding in comparison with other countries’. That attitude has no doubt influenced whether these experiences are pleasurable or aversive.

Ever since the release of Orgasmic Birth, which has screened in 48 countries, countless women have thanked Pascali-Bonaro for making the film.

“For all the women who don’t know orgasm can be a normal function of birth, it can be incredibly shameful,” she says. “A lot of women have thanked me profoundly for giving them the validity that it’s OK.”