It is no secret that the word best describing the experience most women have during the hard work of labor is “pain”. Many of the media portrayals of childbirth, as with quite a few of the stories we hear from others, show us nothing short of this. In fact, in some cases it appears to be much worse than pain – women screaming, crying, calling out for drugs, cursing. It can seem to be an excruciating experience that we barely make it through. But, what about those stories told by women who planned natural (drug -free) childbirth? Some of them even describe it as an empowering and rewarding experience. Do they just have a high pain tolerance? What did make the difference for them? Can the pain of childbirth actually be beneficial to a laboring woman? Why would you want to birth without pain medications if they are available?
First, let’s look deeper at the “pain” of childbirth. Have we always birthed in pain? Well, we can assume at least as far back as the time the book of Genesis in the Bible was written, women were experiencing pain in childbirth.
To the woman He said, “I will greatly multiply your pain in childbirth, In pain you shall bring forth children;…”
Some people think. because of this verse, that it is woman’s curse to experience birth as painful. But, could it be that the pain of labor actually serves a great purpose to ensuring that labor progresses as it should? Could we even embrace the pain as beneficial to the birthing process?
Take a look at birth art in this video clip depicting birthing women of ancient times.
While the women in these depictions, as well as those included laboring naturally from modern day, look like they are in the midst of hard work, none of them look like what we could imagine the women of the stories we hear appeared, or those births we happen to see in the cinema and television. This could be our first clue that the pain of labor doesn’t have to be thought of as working against us, or as a curse to womanhood.
Continue looking at depictions as time progresses, but still before more contemporary ideas of birth came into play.
What is different about these women, than those in the more modern stories and portrayals of birth? The first thing that can be noticed is that the women are upright instead of reclined in the bed. Few of them are actually using the bed at all. They are also supported both physically and emotionally as they are birthing. They are not alone, and they are responding to their body and what is occurring within it.
All types of pain are a protective measure created by our body to alert us to something that needs our attention – whether it be a sore muscle or a heart attack. Depending on where the pain is, and how acute it is, will determine our reaction to it. Take for example the sore thigh muscle. We became sore after we ran five miles the day before. It was the longest we had ran thus far, and our body is responding to the lactic acid buildup within the muscle and actual muscle tears (which is how muscle is built). Some of us might respond by taking a shorter run at a slower pace that day, or others of us by skipping our morning run for a day or two. The acute pain of a heart attack would trigger a very different response. We’d hold our chest. Call for help. Try quickly to find relief by either moving our body, or sitting down and taking deep breaths.
To which of these degrees can we place the pain of labor? Is it somewhere in between the two of these? To find the best way to think about labor pain, one must understand what the body is doing in the work of labor. During labor, the “pain” we experience is due (to the greatest extent) to contractions of the uterus. The uterus is a muscle in the lower abdomen which holds the baby and the baby’s life support system while in the womb. At some point in early labor, the uterus will begin contracting in a way that will become patterned. The contractions will become longer, stronger, and closer together. The contractions of the uterus are not continuous. There are breaks in between each one where the laboring mother will not experience the resulting pain of the muscle working. Contractions work to bring the baby down into the birth canal, and place pressure on the cervix (opening of the uterus) helping it to open (dilate) for the baby to come through.
A shorter muscle will be stronger “pound for pound” (i.e., by weight) than a longer muscle. The myometrial layer of the uterus may be the strongest muscle by weight in the human body. At the time when an infant is delivered, the entire human uterus weighs about 1.1 kg (40 oz). During childbirth, the uterus exerts 100 to 400 N (25 to 100 lbf) of downward force with each contraction.
If we think back to the sore muscle, we can assume that labor pain is a bit more intense than that. However, we might not be too far off to equate it with the actual running. If you have ever lifted weights, ran a far distance, or played an extra competitive game of sports, you might have experienced pain similar to the sort a woman experiences during contractions. The sensations of a muscle hard at work. Again, though, this comparison is a little difficult to imagine, because a laboring woman actually gets a break from this hard work in between every contraction. Also, you must factor in the time spent in the process.
Watch the women in the following video. Each of them are laboring natrually (drug-free). Try to notice how they are responding to the pain of contractions.
The women of this video had the freedom to move in response to their contractions. How can this be beneficial to a laboring woman? As we respond to the pain we will move into positions or in rhythms that help us find relief or comfort. Having the freedom of movement allows us to work with gravity to help labor progress without the use of drugs such as pitocin. We can also work our bodies in ways that will help the baby descend into the birth canal and do so in a position that is good for birthing. By responding to the pressures and pain we feel within our body through movement, we can encourage the baby also to move. If a woman who is laboring without pain medications is restricted to the bed for long periods of time, it is likely that she will experience the pain as being more intense than if she were able to move in response to it. This could be the probable reason for those stories we hear of labor pain being described as unbearable. Many labor practices, such as continuous electronic fetal monitoring, require women to remain relatively still in the bed far more than they would by their own wishes during labor, without making outcomes any better for mothers or babies.
The pain of labor is not meant to be equated with suffering. If the pain of labor does become intolerable, one or some of the various medical pain relief options should be utilized and available for the mother. A woman should not have to suffer through childbirth, and women who choose to labor naturally should not be viewed as martyrs, or extreme. They are not suffering. If they have prepared their mind and body beforehand to understand the physiological process of birth and the things they can do to naturally find comfort, have chosen a care provider familiar with and supportive of naturally laboring women, have chosen a facility for birthing where they will have freedom of movement and access to various comfort measures for birth (showers, tubs, birth balls, squat bars), and are supported continuously through labor by their loved ones and/or a doula, they are likely to experience natural childbirth as a triumphant event in their lives. It is a time when they have experienced their female body to its fullest capacity. It can be an empowering experience. The pain of labor is not a curse or an enemy and can actually be an asset to the birthing woman, helping her to avoid various medical interventions, and aiding her have a healthy birthing experience for both herself and her baby.
Many happy days to you and yours,