Monday, February 8, 2010

Pain

I have no qualms about telling women that childbirth can be very intense and painful. I in no way, shape, or form believe, provided I am not speaking about it as if it's a horrible, frightening thing they should never try to attempt, think that to believe it CAN be painful, necessarily makes it so.

I have seen a few people have reasonably painless births. They were flukes, even according to the women themselves. There were no Vulcan mind tricks. I myself have had varying degrees of pain in my four birth experiences, ranging from almost none, to "where's the window, I wanna jump!" I don't think, "hmmmm, I must have been afraid or distracted, and this is what caused more pain," because, except for one, I have had phenomenally beautiful, unfettered, physiologic birth experiences. I am aware of yoga breathing, unfocused awareness, vocalization, visualization, affirmation, yada yada. I have practised all of them. They have been very useful tools in keeping me calm. But they didn't make me not feel pain. Would you like to tell me I did something wrong?

It gets my knickers in a twist when I hear women told they are "losing control" or "not breathing correctly" or "not relaxing enough", the implication being they are feeling pain because they're doing something wrong. I also HATE the simplistic, condescending, paternalistic phrase, "pain is a signal something is wrong in the body...because childbirth is good and natural, it shouldn't hurt." Can you imagine someone buying this crap, forking out money for methods to change "beliefs" about the hype of pain, practising for months, and then, upon experiencing pain (which, not to pick on any particular method, but MOST women WILL feel regardless), feeling like a total failure because their "sensations" were painful? Self blame? Unworthiness? Cliche? Not part of the club anymore? Not a healthy start to motherhood, I'd say.

I DO believe that undue fear and tension will increase the sensations of normal birth in a way a woman may perceive as negative. This is a physiological reality. We know that bad stress hormones will not allow for the free flowing of the lovely hormones we need to birth as pleasantly as possible. I DO believe the more we relax the more enjoyable the sensations can be regarded as, even if they hurt like hell. Pain doesn't have to be negative, and this is the point I think people are missing when they seek to "control" and "manage" the pain of labour, as if perceiving labour as painful were a pathology in our warped thinking.

I am not a masochist at all. I'm not a glutton for punishment. But aren't there some painful sensations that are rather nice too? Having a good massage which can hurt like crazy in some ways but feel oh so delicious at the same time is an example. So is engaging in much wanted sexual relations for the first few times in one's life, or trying out something a little kinky, which may bring on some intense sensations the body can interpret as painful, but profoundly exciting at the same time. And even though it's natural and good, giving birth isn't the only rite of passage that is painful. Being born probably causes you some pretty spectacular sensations, no matter where and how you're birthed. And, as I mentioned, sex for the first time can too. For many, the deep ache of menstruation isn't particularly distressful. It's a signal that the body is working hard to achieve something, and experiencing a process that requires attention to care for oneself physically and emotionally as much as possible. Some actually like that pain. Personally, I quite enjoy that pain, and I don't believe my experience of some achiness in menstruation is a sign of misalignment, malnutrition, or emotional distress, because I know what it feels like when those things ARE present, and then it's not fun anymore. Finally, exiting one's body probably involves some pain too, as the cells die and the system lets go of functions it's done for an entire life time. We all have to die, and many die in peace, even if there are some really interesting sensations involved.

I have worked with quite a few people who have thought if they just believed it hard enough, and worked their "program" hard enough, they'd come through labour able to say they had orgasms instead of pain. The ones who were orgasmic were not the ones who "tried" to be so, and the ones who worked particularly hard to get there are often the ones who end up perceiving the pain and feeling badly about it. Dude, there's a BABY coming through your CERVIX...and VAGINA! Do you really think you can just "ohm" or "visulize" that discomfort away? It's true, to some, like with the birth of my third child who was born in the caul, I don't remember much pain upon transitioning and crowning. But I certainly didn't do anything special to make that happen. The baby after that really really hurt, though I felt the same confidence and embracing of the sensations of birth. I certainly didn't feel cheated, though, because it was a gorgeous birth all the same.

No, childbirth doesn't always hurt, but don't think that just because you invest a lot of time, money, and effort into a method that professes it can make it so, makes it so. In fact, some of my experiences with those who have used methods such as these have ended up with exceedingly long labours. My thought is that perhaps they are working so hard to be Zen and controlled, they stave off the inevitable sensations that are needed to get those big waves crashing and a baby born.

I just love being with a woman when she is experiencing the last leg of dilation, especially if she's never done it before. Even if she's not experiencing it as overwhelmingly painful (because I have seen lots of ladies come to the end of birth and say, "Thank God! I thought it would be so much worse than that!"), the sheer INTENSITY of that pull of Baby moving down and the uterus squeezing with shocking force, is POWERFUL. It is fierce, and awesome to behold. I call a spade a spade. For me, that sensation HURTS. Like nothing else in the world. Yet, I would still rather have that pain than have to endure a night of food poisoning, because as far as I'm concerned, that intense birthing, life-giving, purposeful pain is normal. Food poisoning is not.

I believe it is far more effective for a woman to learn ways that appeal to her to cope with the sensations of birth without reacting with fear, like using breathing, vocalization, etc. And I think it's helpful if she does this without holding the expectation of painless birth. Preparing for the reality that MOST women find birth painful to some degree with tools to help reduce tension will, in my humble opinion, make birth seem far more pleasant and do-able than going into it with an "arsenal" of tools "against" pain, or of a mindset that attempts to deny it. Because then, if pain hits and your expectations are blown, you are going to lose your sense of humour. You risk not looking back upon the experience as thrilling, marvellous, and YES painful, but so so so worth it given how high those sensations made you during and after. Instead, you're going to be wondering what you did wrong. And if you did do something fancy that resulted in the birth you wanted, with no pain, then I am truly happy for you. That's GREAT! I, personally, would not trade a moment of my experiences, painful or not so much. Having felt pain makes me feel like I was strong and capable, not a failure for not having been evolved enough or disciplined enough to know the right tricks. And having experienced intense sensation without pain was awesome too, but not the thing that defined the labour.

7 comments:

  1. I disagree that the sensations of births are "painful"...just like I disagree that other examples that you gave for positive pain (massage, sex) as being painful. Intense to be sure...but I wouldn't say those things are painful.

    I think that birth is a more intense feeling for most people than anything else they will ever feel, including most any types of pain (which most definitely is a negative thing) you will experience....but I don't believe it is pain as pain is a negative thing.

    I wrote about this on MY blog as well..
    http://www.nurturingheartsbirthservices.com/blog/?p=16

    I believe that the reason most women call it "painful" (and I'll absolutely agree with you that most women come away calling it painful, no doubt about that!) is because there isn't a word in our language to describe the sensations and "painful" is the most intense word available to us so we use it. Vita Mutari is latin for "Life Transformation"...and that's what I believe birth FEELS like...not pain (which yes, is negative) but vita mutari...labor/birth is vita mutari...

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  2. Thanks for your comment. To each his own. I personally found birth very painful, and wonderful, and it is a word that comes up for most women giving birth. We can pretty up the language all we want and identify labour sensations' unique, life giving qualities all we want, but I don't think it changes anything. I just don't think there's anything wrong with the fact that it's often painful.

    I don't think pain is a negative thing at all. That's too black and white. Pain can be an impetus to heal, a herald to change and grow, a signal for help. It is what it is, and I just don't think attaching "negative" to all things painful is the way to make people believe the sensations of birth are NOT painful. I'm a realist, and I'm practical. It's okay for birth to hurt.
    It's an interesting argument...I just don't buy it...and don't think many others will, either. This vita mutari? Still hurts for many folks:) And that's fine. The sensations of birth are far too individual for each woman to wrap up into a package for you to define for her. If she says it's painful and you tell her, no, pain is negative, that's not what you experienced, you may be dishonouring her. Just as if someone tells me it didn't hurt, I'm not going to say, "oh yes, it did!"
    Again, thanks for your input! I love to hear what others think.

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  3. A rose by any other name would smell as sweet. I have to agree with motherwit here. This is an argument in semantics. Childbirth can and usually is a very "intense" event. Whether you call it "painful" or not does not negate the physical feeling. There is a definite physiological happening going on. Pain receptors are stimulated by the stretching and other tissue "trauma" during delivery, there is definitely Nociceptive and Somatic Pain in childbirth, whether that is interpreted as negative or positive is dependant on the individual experiencing the pain only.

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  4. Yup. And I don't worry about telling women that most perceive it as painful. I don't think we're so fragile and brainwash-able that to say it makes it so. I have had many women go into birth believing it will probably hurt, only to find it doesn't for them. I expected my third birth to be long, hard, and harrowing..it was 43 minutes and there was only 1 hard contraction involving pain. Birth is too individual and random for us to pin down. Yes, relaxation and positivity influences how we deal with it. But to believe IF we do something a certain way and IF we simply refuse to believe the nociception process isn't painful, doesn't necessarily grant us our wish. Now maybe sacrificing chickens....

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  5. I felt as if my labour was extreamly painful, but there was trauma to the inside of my uterus, one layer of my uterine scar opened. I know the exact time and sensation of when that happened, that's when it became painful. Before that moment though, it was an intense wave of heat that I could move/breath with. I try to tell moms that labour is hard work, intense and that the more comfortable they are in their surroundings the less that intensity feels like pain, though towards 8cm dialation, when we are most tired is when most women perceive this intensity as very painful. But luckily that is a very short part of the labour.

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  6. Yes, thank God. My second labour was super painful, but I had a posterior, asynclitic baby. Oy, the back...I was in more pain at 5cm with that than I was for most of the transitions of my other kids. Otherwise, if all is going well, while I still find it achy and mildly painful, it is fun and enjoyable. Transition hurts me, though. Can't find the magic words to make it otherwise. And yet some other women feel better in transition than in other points of labour. Everyone is different. There is a desperate human tendancy to pin birth down with expectations.

    And it's not always true that the more comfortable a woman is in her surroundings the less pain there always is. We are veering into magical thinking here. I think we have to be EXTREMELY careful about this theory. I think the more births one attends, the more one experiences this truth: yes, comfort helps overall, and makes the perception of birth wonderful when it's done. Even in lots of pain, the nourishing environment helps the mother cope. But I have seen many women just having delicious, beautiful labours, totally surrounded in an environment of love and beauty and trust, and STILL wig out with pain during parts of their normal labours, yelling, "It HURTS!". I trust a labouring woman's cerebral functions are taken over enough by Labour so that what she's yelling out is authentic and true...there is pain! She's not saying, "This is intense and huge and crazy." No, it hurts.

    To create a preconceived formula of how birth should be if everything is in place is to think there is some sort of control, which there is not. It is the same idea as trying to fit labour progression into a curve. Just let it be. It isn't something we "achieve", it is something which "unfolds"...pain or not.

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  7. I just want to say I don't mean to be harsh with anyone here. I have learned many a hard way how birth expectations, if they don't work out, make women feel badly. Our intentions are to make labour sound really positive so they don't go in scared, which makes them tense, thus makes them feel more pain. I get that. And those are really good intentions. But those intentions don't guarantee anything. I want women to take responsibility for their sensations, and if they experienced pain, to know that they were AMAZING for having coped and come through beautifully, not somehow broken because they were missing part of the formula. You may be able to tell, I've had some pretty challenging experiences in the not so distant past :) Woman are heroic, no matter how they experience pain. Let's not put negative labels on it. Anyway, I'm only giving my 2 cents. It's not as if I actually know anything for sure.

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