Tuesday, October 5, 2010

labor pains

More and more women seem to be exploring the option of a natural birth for their child.  Excuse me ... we'll call it normal childbirth instead of natural, as normal includes the use of minimal hospital interventions, which are sometimes needed and even life-saving.  We are learning that normal birth is healthier for us women and our babies, that birth is indeed a perfect process in and of itself without our human meddling, and that major abdominal surgery is just that: major abdominal surgery.

But cesarean rates are still climbing; today one in three women will end up with one.  We know that any medical intervention -- induction, pitocin, epidural, etc. -- greatly increases the likelihood that a cesarean will be necessary.  So why don't we abandon it all and welcome that little one into the world the way nature made us to?  Well, it's simple, really.


Pain, pain, pain.  For a woman without high risks, it generally boils down to pain.  As women, we hear over and over again how hard and how painful it is.  In my growing-up years, most of the experienced women I knew had epidurals, and so from what I heard, any feeling of anything most definitely felt painful, especially in comparison to the blissful state of numb.  Epidurals do not last forever, and so at some point something will likely be felt.  How could I not be scared?  I learned about the process, I obsessively watched the births that were dramatic enough to make the cut to Baby Story on TLC, and asked everyone I knew what birth was like.  "Like a cramp on steroids."  "Like knives cutting you up from the inside out." "Ring of fire!"  These were all common responses I heard.  I went into the birth of my son scared but determined to push through, my brain completely muddled as to the decision of medication.  I knew narcotics could effect my baby and make me drowsy.  I knew epidurals could slow labor, keep me from being able to push like I should, give me a 50% greater chance of a c-section (which I was mortally terrified of), and in rare cases cause breathing problems, nerve damage, or heart damage.  (Most recently I learned that there is no real research on the effect epidurals have on infants. Why ...??)  But more than all of that, I knew it would hurt.

There were, however, two women in my life who told me it really wasn't that bad.  They said in was hard for sure, but really not that painful.  Were they superwomen?  Insane?  They both ended up doing home births for a couple of their kids, so in my mind they might have been.  Did they just have the perfect hips/uterus/cervix to birth a child?  Maybe.  But I think something else came to play.  I think, more than anything, it was their perspective.  They knew what birth was in its entirety and planned to just do it.

According to my handy-dandy DONA workbook, under periods of stress men are instinctively geared to resort to "fight or flight".  We've all heard of that.  But according to this, women resort to "tend and befriend" (meaning protect offspring and seek supportive networks).  That's new to me, but it makes a lot of sense.  This has some major effects on our bodies:  dilated pupils, increased oxygen uptake, blood supply taken from internal organs and pumped to the muscle, increase in heart rate, increase in blood sugar, and an increase in estrogen.  If you are in labor, this results in:
  • Decrease in blood flow to uterus
  • Decrease in uterine contractions
  • Increase in duration of first stage of labor
  • Decrease in blood flow to placenta
  • Increase in fetal production of catecholamines, which results in fetal conservation of oxygen and heart rate deceleration
  • Increase in negative perception of events by woman
  • Increase in need for reassurance and support
  • "Fetal ejection reflex" (rapid expulsion of the fetus)
Crazy, right?  In the beginning of labor, too much anxiety stops it altogether.  That makes sense though.  If you're a neanderthal in labor and a sabor tooth tiger shows up, you're going to want to run away.  If your today's woman and you get to the big hospital and feel more nervous than comforted, your body will have the same effect.  In either case, anxiety equals more pain.

Is there any way we can conquer that cycle?   Two ways:  numb the pain, or calm the mind.  Every woman has to make her own choice; the birth will be whatever she says it is.  If it's wonderful because she couldn't feel anything, or wonderful because she brought that baby into the world with her very own body, it's still wonderful.  We are lucky enough to live in a time where we can choose between the two.

But for those that want to do it themselves, it's a bit trickier.  My training as a doula involves all sorts of massage, encouragement, and information.  To get the first two, you'll have to hire a doula (or convince your partner to study and practice like mad).  But the whole purpose of this blog of mine is to share some of that information.  So let me share two things that really changed my perception of pain.

First is that the perception of pain is just that, a perception.  It is completely in your head.  There are all sorts of classes like hypnobreathing, lamaze, and yoga that help prepare you to respond to the contractions in a more positive way.  Ellie Shea, my trainer said to us:  "It seems our society really fears pain.  Which is interesting, because they will go through all sorts of pain to run a marathon, or even just to go to the gym.  Pain in childbirth is more similar to that than anything else."   She also talked about a doula who's client started voicing frustration at how hard it was, and her doula replied: "They don't call it labor for nothing."  Which is true; it is hard, hard work.  But it is just that: work.  Work your body is built to do.

That brings me to my second point: your body is built to give birth.  It just is.  I happen to be a religious person, but if you are not, call it nature or the cosmos or whatever -- we have been created to be able to give birth.  It's just part of life for us, ladies.  Birth is a perfect process, every part of it was put in for a reason.  When you are in labor and your back aches, move.  It's usually the baby trying to get in the right position.  If squatting on something relieves some pain, do it.  It could be that it's opening up your pelvis.  Labor pains are pains with a purpose.  They get you somewhere.  Somewhere a lot more important than the finish line of a marathon.

So, as cliche as it sounds, trust your body.  Expect it will be hard.  But know that you can do it, however you decide to.  Don't be afraid.  That baby needs you to be confident, empowered, and full of love.  You are about go through the most intense moment of your life, physically and mentally.  The life of you, your partner, and your little one changes forever.  Human beings are incredibly resilient and can bounce back from anything, but your family deserves to start out right. 


  1. Love the new blog! :) PS you should watch "The Business of Being Born." I don't know if you have Netflix, but you can stream it from there online.

  2. After reading your article I felt...whats the right word: empowered, motivated and excited! I like how you view things and once again appreciate your thoughts.

  3. Dani ... LOVED the movie. Heather I am glad! You can do anything. Hope you are feeling well!

  4. I found your blog by chance and I'm loving it... I'm from Italy and pregnant with my first, due in january. Just wanted to thank you for all the lovely posts, really, so useful :)