Monday, January 12, 2009

How bad is the pain in childirth?

How bad is childbirth?

This is a question that everyone who has ever thought of being pregnant, or is pregnant wants to know. It is also the question that nobody can describe or explain. Ask a hundred women, get a hundred answers. One woman may not have any pain at all during birth, while the next says she would have died with pain medication. Though I cannot begin to explain what childbirth feels like, I would like to write about the various reasons why women find childbirth to be different.

There are many factors involved in how a woman handles and perceives pain. We all have a certain pain tolerance, when it comes different things. Some women need a dark quiet place with prescription medications to deal with a headache, while another person may take an over the counter medication, and go about her day. We all tolerate childbirth differently. Not everyone with a low pain tolerance, finds childbirth intolerable.. Not everyone with a high tolerance to pain, finds childbirth a walk in the park either. So we know there are several other factors involved here. Tolerance is certainly ONE factor, but it is not to be the sole contributor in childbirth.

The second factor to consider is our expectations. Some women expect labor to be so horrendous, that when they actually go into labor they do one of two things:
~ They either start screaming right away for drugs because they fear what is to come
~Or they end up finding labor so much easier than they thought that they go through labor and delivery without drugs.
Alright, now I know that the two things listed above are not the ONLY scenarios, but it gives you an idea of what I’m trying to say. It’s kind of like this: My husband likes to watch movies.
He likes to critique them. Sometimes he’ll read reviews before he watches the movie. If everyone is giving it good reviews, then he has high expectations. Sometimes, he walks away very disappointed, and can’t understand why the movie was rated so high. This is a huge let down. If he has heard really bad things about a movie, and he watches it knowing not many people liked it, he might be pleasantly surprised. Sometimes it’s better to watch a movie without listening to all the reviews, and decide for yourself. Same goes with labor. Not everyone has the same tastes.

The third factor, coincides slightly with expectations. It is trust. How much does the pregnant mother *trust* herself, and her ability to give birth? More and more, women are excluding themselves from the rest of the women in all of history who gave birth. They are different. Something is wrong with their size, or their shape, or perhaps they have a medical condition that they feel changes their ability to give birth. Their baby is much too big, and their body is not capable. The list goes on. Women no longer trust birth. There are people who literally believe that it is impossible for a woman to give birth without pain medication of some kind. Lack of interest and/or misinformation has caused a huge population of women to loose this simple trust.

When there is a lack of trust, there is fear. When there is fear, there is pain. This has been scientifically proven. I’m not going to go into details here, but most childbirth classes will explain how this works. Just remember: Fear = Pain

Now we are going to discuss the various external things that can cause labor to feel differently - sometimes causing more pain. Let us take a walk into our virtual minds of a hospital room where “Angela” is laboring. Angela is laying on her back in the hospital bed being monitored. The nurse asks her to rate her pain on a scale from 1-10 (ten being the worst pain). Angela says she is at around a 6 on the pain scale. She’s not a happy camper right now. Now, rewind the movie. Let’s go back and change this movie up a little bit. Angela has come into the hospital in labor. She is standing up with her arms around her husband, friend, mother, sister or doula (you get the idea), and during a contraction, she leans into them and hangs ever so slightly while she sways her hips. After the contraction, the nurse asks her to rate her pain. Angela replies “a 3". What do you suppose changed her the ‘feel’ of her contraction? No, Angela has not had any drugs. Read on.

There are several factors involved that explain why she felt worse in bed. First of all, her support was activity involved. They are willing to go the extra mile, and do what it takes to get her through a contraction. They are supporting, and giving her full confidence in her ability to do this the way she wants..naturally. And they are willing to go through a bit of pain to help her.

Secondly, she is standing up and leaning forward through the contractions. Science shows us that when a woman has a contraction, her uterus tilts forward. When a woman lays on her back, the uterus has to fight gravity to tilt forward, so it has to work harder. The uterus is a muscle, and we all know that the harder you work your muscles, the more pain you feel. The uterus is certainly a very strong muscle, and can withstand a lot of hard work. But why put undo stress on it if it can be avoided? The more work it has to do, the harder the feel of the contractions. The moral of this story? Help your uterus do it’s push ups! Stand up, and lean forward.

There are more benefits for standing through labor. All the nerves to the uterus lie in the lower back. These are the ones that tell you when you feel pain. When a woman avoids lying on her back, there is no direct pressure to those nerves, so she feels less pain! Another reason that standing up helps ease the pain of a contraction is oxygen. We know that when we are running, or exercising, oxygen plays in important key to keeping the muscles from being in pain. When you become out of breath, the muscles start to spasm. We know that when we have pushed it too hard, we need to stop, catch our breath, and let our muscles relax. When Angela was laying in bed, her uterus was squishing up more into her chest cavity. Her diaphragm was being squished more, and so it was harder to get all the oxygen she needed to supply her uterine muscle. When standing, Angela’s uterus was able to have more room. This also gave her diaphragm and lungs a tiny bit more space too. More oxygen was able to get to her uterus, and that helped ease the pain a little bit.

Although position is a huge factor in how a woman feels each contraction, there are still many more. A woman needs to feel safe, secure, and cared for (or supported). Her breathing, and how well she can relax makes a huge difference. Are there medications involved? Things that make her feel uncomfortable (monitors, IV’s, etc)? Is she allowed to use a tub, or a shower for pain relief? Is someone rubbing her back and giving counter pressure? How about belly lifting? Applying hot or warm compresses to her belly or back? Can she eat and drink during labor? These things can make natural birth so much more bearable! I could give you more detail on how these other things help during labor, and I could also give you all the information about how our body provides awesome pain releasing endorphins 10x more powerful than morphine, but I’ll save that for your childbirth teacher to tell you.

We cannot strip a woman of every available method of reducing pain, put her in a hospital bed, on her back, and expect her to cope with labor! We cannot have the attitude that this is painful and the pain can’t be reduced by any other means (other than drugs). We need to open our minds to the fact that birth without medications is always better for both mom and baby. We need to start supporting the idea that birth is something ‘do-able’ just as every women in the world did, before the inventions of narcotics and epidurals. Mothers: You can do this!!!


April said...

Hey, I just wanted to say that was an amazing article! Very helpful and encouraging. It's hard not to get freaked out when nowadays everyone is telling you how terribly painful birth is and how you just can't manage without an epidural. I feel excited and empowered to go all-natural. Birth does really seem to be what we make of it! Thanks again for the article.

~The~Birth~Teacher said...

You are welcome! Thank you for your kind words.

pinky said...

Interesting post. I must disagree on one point. I don't think women before us trusted birth so much as they accepted birth. They did not fight it as much. My Grandmother has 3 children at home. She told me you just gotta go along for the ride. Fear will not serve you.

Drofen said...

Excellent post!!

In the birth our son, my wife decided that she really did want drugs even though we'd discussed having a natural birth. At that point in the game I wasn't going to argue with her when my trying to be supportive and keep her close to her wishes wasn't well received. Unfortunately while they tried to bolus her with IV fluids her water broke and we had a baby in less than hour. Because she was still attached to the IV she was not allowed out of bed. For all the reasons you described, I think her labor was much more intense than it had to be. She did it all natural, no pain meds at all, but I doubt she'll want to go down that road again. :(

~The~Birth~Teacher said...

Thank you pinky, for your comments. It is true that our grandmothers, even our great mothers accepted birth probably more than they trusted it. This century has done a lot to scare women. I don't know how women thought prior to this century, but I'd be willing to bet that if we could ask them about childbirth, they certainly trusted the process much more than those today. I like what you said about fear not serving us. This is true, and I'm sure that fear has been a factor in many centuries before us. But even with the fear, I can't help but think that they still trusted birth. I think of those in under privileged countries. You know, the women who give birth while working out in the fields, and then get up and go back to work? It is that type of trust and simplicity that I speak of. They trust it, much more than most (at least in the USA). If only we could adopt that simplicity...

~The~Birth~Teacher said...


Thank you for writing. I enjoyed reading your story. Your wife did great, especially riding out those last few contractions with ruptured membranes. I have to say that contractions certainly can be much harder to deal with after that! I don't know how long ago she gave birth, but time does have a way of softening the memories -especially when there are no drugs involved. Should you both decide to have another one some day, you'll just have to see how much she remembers! :-D Good luck to you both.

Homeopath said...

I noticed that one of your interests was homeopathy. I am new to blogger but intend on postings some more interesting entries there that you might enjoy. I’m trying to enlighten people about homeopathy. Your blog is great.

Anonymous said...

Hi Trisha!

Sorry I haven't been hanging around in blogland lately; my hubby has been home so I've been hanging with him as of late.

Thanks for writing!

Big Green Serpent said...

Could pain really become a thing of the past?

~The~Birth~Teacher said...

Big Green Serpent:

I have no idea :-) I don't think it will ever go completely away. It's a nice thought though!

Jessi said...

I wish I had had someone like you around for my first birth. I was so scared and forced to remain in bed because of seizure level blood pressure.
With my second I was on pitocin and wasn't given the chance to walk around and get my labor started on it's own(my water had broken about 12 hours prior) I had been sitting around because I thought I was peeing myself every time I moved. So I didn't move! When I did walk I had some mild contractions and felt that if I'd been given a little time to get it moving on it's own I could have avoided medical intervention. My first birth happened from first contraction to baby in under 8 hours. They broke my water when I was at 5cm(I was at 3cm at 7 months) and it took an hour from my water being broken to being fully dilated and delivered. The nurse LITERALLY caught my baby as the doctor had left me telling me I had 'hours to go'. With my second was under 2 hours from checking in and paper work to delivery. I was on pitocin for less than an hour before delivering my baby boy.
Next baby I may just plan for a home birth as I may not have time to get to the hospital(and I hate being handled and confined to bed!)

The nurse was awful too. I sat up to go pee and the baby(#2) slammed down into my pelvis hitting my pelvis and it hurt, she told me 'get up, it doesn't hurt it's gravity helping' but when he was born, he had a GIANT goose-egg the size of my palm on the side of his crown where he hit.

ok, sorry bout the rant. Love your blog.

~The~Birth~Teacher said...

Hey Jessi!

Thanks for posting. I'm sorry you have had some bad experiences. I think you will find some healing with a homebirth. I wish you all the best. If you ever move to the Dallas/Fort Worth area, and are expecting, look me up!
P.S - Should you find yourself blessed again, consider a doula as well! Take care :-)

kesi said...

I plan on a natural birth for my first with spontaneous pushing and lating on my side whrn its time for pushing i plan on walking around and doing exercises before its time to push .. People who have had children with meds say ow its not that simple u cant do it i think some moms feel jealous when theres someone who had a natural birth and they know nothing about how that feels it pisses me off when they doubt love your blog