Pain vs. Suffering
For many pregnant people, the main fear and anxiety they feel regarding their impending labor and birth is about pain. The media portrays labor and birth as a scary, painful experience which is a sort of "right of passage" that one simply has to endure and move on--either that, or get an epidural and "avoid all pain." There is a lot wrong with how the media portrays childbirth, and what is especially important about this issue is that, for many pregnant people, this is the only exposure they have to labor/birth at all before doing it themselves. Let's dive a little deeper here.
This "pain" people are talking about when one is in labor is caused by physical sensations that result from the uterus contracting, or tightening, to help baby to move down, engage in the pelvis, and ultimately make their journey through the birth canal to enter the world. Uterine contractions get stronger, longer, and closer together as labor progresses, making the most intense "waves," or "rushes," as they're often referred to as, toward the end of labor. Of course, the journey to get to this point involves less intense rushes/contractions leading up to it.
Side Note: So, what causes these contractions to happen? The uterus is told to tighten, or contract, when the hormone oxytocin is released in the body. Oxytocin is often referred to as the "love hormone," as it is the same hormone released when you kiss a loved one, pet a dog, or feel overjoyed for any number of reasons. Oxytocin is only going to be released if you are feeling calm, safe, and supported. I'm not going to go in depth now about oxytocin, but that will be the topic of a future blog post!
Back to the sensation of contractions! The uterus contracts and these contractions get more intense as time moves forward and labor progresses (if contractions do not get stronger, longer, and closer together, or if they stop completely, perhaps oxytocin is not flowing as it should be). When we feel contractions, it is how we cope with them that causes, or does not cause, what we call "pain."
Enter the "pain, tension, fear" cycle (see slide below)! You can start at any one of these points and the cycle will continue to feed itself, UNLESS you find a way to break the cycle. So while contractions can cause pain, the more pain you feel you might discover fear setting in--fear of pain getting worse or an inability to cope effectively with the pain. When we feel fear, it is like the fight or flight reaction. This causes the hormone adrenaline to skyrocket in our body. Adrenaline is the antagonist of a labor story--it is the opposite of oxytocin, what we want to be flowing in the body. So if less oxytocin is flowing, contractions are not going to be as effective, and they will slow down (the opposite of labor progressing). And this cycle will continue...
The key here, then, is to break this cycle, as I mentioned. How do we do that?
We need to feel calm, safe, and supported.
We need to NOT feel FEAR.
We need to be prepared with coping mechanisms for the sensations, and educate/empower ourselves before our birth (take childbirth education, write a birth plan, foster positive communications with our care providers, review trusted resources for labor topics---Evidencebasedbirth.com, Lamaze International, Childbirth Connection, Motherboard Birth, etc.)
And Number 2 is the hardest part--if you are scared of labor pains and do not realize that birth is a normal, physiologic process that does not need to be intervened with unless there is an issue, then this cycle is going to continue throughout your labor, and can cause more issues than it solves. This is HARD, as media has taught us that labor and birth are things to fear. But we can stop these fears by becoming informed consumers of the health care system and by educating ourselves about how to cope with labor effectively!! We can fill our so-called "Labor Toolkit" with ways to COPE WITH LABOR SENSATIONS (another blog post coming...)!!!
Finally, I want you to watch this video by the incredible Penny Simkin, who sums it up perfectly. Feeling pain, or intense sensations/rushes/waves, whatever you want to call contractions in labor, is NORMAL. These contractions are PRODUCTIVE, not indications of something wrong or bad happening in our bodies. It is how we COPE with said pains that determines whether we will suffer or not. And NO ONE deserves to suffer in labor. So, build a supportive birth team, fill up your metaphorical "labor toolkit" with coping mechanisms, and make sure you feel educated and empowered going into your labor, and you will rock your labor pains.
Side note: You might be wondering what this "labor toolkit" is I am referencing. What I mean by this is comfort measures that are known to be effective in labor (movements, acupressure, massage techniques, aquatherapy, aromatherapy, audiotherapy, etc.), knowledge of other non-pharmacologic pain relief measures (i.e. nitrous oxide), and knowledge of your options for pharmacologic pain relief measures (i.e. epidural, narcotic analgesics, etc.). These are all things you can learn in a childbirth education class or by asking a doula, care provider, or nurse.