As I’ve mentioned earlier in this home birth series, I have become convinced that epidurals are not a free pass on the pain of labour, and part of my reasoning for choosing home birth is my commitment to not have one unless it becomes medically necessary. I am not morally opposed to epidurals at all, and I do not think I will be more of a woman for birthing a child without one, but having decided that I would rather go without one, I am obviously faced with how I will cope with the pain of labour (incidentally, not everybody agrees that labour is a painful experience, but I’m not counting on an ecstatic birth experience either).
This is the hardest topic for me to write about because I can do all kinds of research and hear all kinds of stories from all kinds of moms, but when it comes down to it I just don’t know what to expect. I am so aware that I could very well look back on this post as hopelessly naive, but at the very least this will be a record of what I’m thinking now.
Before I get into coping with pain, I’d like to talk about pain in general. First off, pain is not necessarily suffering – people go through pain in many situations where it is simply accepted as part of the experience. Strenuous exercise is painful, but people put themselves through it up to multiple times a week. Women often wear shoes that cause them pain for a whole night out, but it’s worth it to look and feel glamorous. People who get tattoos or piercings bear the pain of those procedures as an investment in their self-expression, and I’m sure there are even more examples you could think of!
I saw an internet “fact” that women in labour experience pain equivalent to 25 bones being broken. That’s horrible! First of all, fear and anxiety only make the perception of pain worse so putting that idea in women’s minds will probably make their labour more painful. Also, I do not think labour pains should be compared to broken bones because bones were not made to be broken, but babies were made to be born. Some experts say that the pain of labour cues the mother to move in ways that help the baby position itself properly and to assume postures that make it easier for the baby to navigate the pelvic cavity.
Pain also triggers the release of endorphins in the brain, which act as natural pain killers. Obviously most women do not find their endorphins completely eliminating the pain, but the body is set up in such a way that as pain increases, so too does a person’s ability to cope with it. As the intensity of labour increases, so does the release of endorphins which not only modifies perception of pain but also the perception of time and place and helps you forget the pain once it is past (hello, families with multiple children!). Endorphins also contribute to the elation that women experience once the baby is out (it’s not just relief, but an actual chemical high that your body produces). Not only do endorphins offer all kinds of benefits to women, but babies also receive the same effects while they are being born (not an easy task) because all the hormones a woman releases during labour cross the placenta into the baby’s bloodstream as well.
If all this is true, why do so many women say that labour was the worst/most painful thing they’ve ever experienced? Part of the reason might be because how our culture deals with birth, the broad perception that suffering is inevitable and extreme, and the environment in which women are commonly expected to labour (under bright lights in hospital rooms surrounded by strangers) all lead many women to produce adrenaline instead of endorphins. Interventions that involve Pitocin or other drugs being administered also interrupt the feedback cycle of pain and endorphin release and can increase a woman’s production of adrenaline as well. Adrenaline cancels out the feel-good effects of oxytocin, which includes endorphin release, so women’s perception of pain increases. More stress means more pain means more stress in a vicious cycle, and no wonder there are so many horror stories of women who are traumatized rather than empowered by the births of their children.
So back in September I had been reading a very rah-rah natural birth book and was all excited about embracing pain in labour as part of the process and not being fazed or thinking about suffering but just taking each contraction as it comes and… basically rocking labour. Then one morning I woke up with cramps, just like menstrual cramps except they lasted about a minute and came every couple of minutes with total relief in between. I called the midwife who said it could either be preterm labour (a miscarriage) or nothing, and it turned out to be nothing. After a few hours the cramping stopped, I spent the rest of the day exhausted like I had been kickboxing all morning, and I realized that the little sample of labour pain that I might have just been through had been terrible – not the kind of thing I could just “embrace” and it would disappear. That was disappointing.
I’ve been a little bit re-inspired lately though in my abilities to cope with pain in labour because I have had a bunch of really painful chiropractor appointments. I’ve been having pain in my low back and down my tailbone, and the joints between my pelvic bones and tail bone are jammed, so it’s not something they can just crack and it’s fixed. Instead they are working to release the muscles that are knotted up so that the joints can loosen and move properly. The muscle work basically involves my chiropractor finding the knots and pressing on them while I move my leg through a range of motion. The knots are like pain capsules buried in my flesh that explode under pressure and then morph into increasingly fiery burning pain as I move my leg. It’s brutal because I am the one who worsens the pain by my movement, so as the pain builds I have to accept that it will only get worse and will myself through the motion.
Since seeing the chiropractor I have been taking a break from massage therapy, but that is another area when I am pretty experienced at forcing my muscles to soften and relax under really painful pressure. I know that tensing up against the pain will only make it worse and work against the masseuse, and the pain is not a symptom of anything being wrong other than my muscles carrying too much tension all the time.
Basically my mentality towards pain in labour at this point is that pain will come but dreading it won’t make it any better, and resisting it won’t help either. If I suffer, I suffer, and maybe I will look back on myself with pity or rage for wanting to experience the toil of labour, but at this point I really trust the process, pain and all, and I want to give myself the best chance at achieving it. If I change my mind or get lost in the pain, then I will be grateful to live in a time and place where the government will pay for my epidural – that’s amazing. We will go the hospital and whatever pain I face in the delay between decision and epidural will be the cost of my gamble.
Oh, I should mention we’re planning to rent a birth pool, which I have heard is amaaazing for helping to cope with pain in labour. Apparently for a woman to be submerged in warm water that is deep enough to cover the top of her uterus has the same effect in lowering her perception of pain as a shot of Demerol. But without the side effects or interruption of the body’s coping hormones. So I’ll let you know how that works out!