Pain is a part of our lives - it' an unfortunate and unavoidable part of being human. Physical pain, emotional pain, psychological pain... From the minute we exit the womb, we begin learning coping mechanisms to deal with pain. There are so many factors that influence these mechanisms, I can't even begin to go into them. I'd need three separate blogs, or an academic thesis, to discuss all the sociological, religious, interpersonal, and psychological factors that influence how we deal with, and respond, to pain.
When a woman becomes pregnant, after the "
congratulations" and "
oh, how exciting" statements cease, one of the first topics of discussion that arises is how she'll labor. Mainly, how she'll deal with the pain of labor. It's a legitimate discussion because being pregnant, laboring and birthing a child is - undoubtedly - painful. But what has always baffled me is the social perception of this pain. I feel that perception can sometimes trick women into fearing the pain more than they should.
When I was a freshman in college, I broke the toe closest to my pinky. I was being picked up by my parents to be taken to Des Moines for Thanksgiving holiday, and when they called to let me know they were leaving I jumped out of bed and - rushing to get the phone so I wouldn't wake up my roommate completely - kicked the edge of my bed and broke my toe. The pain was
excruciating, and that is no understatement. That literary image of tears springing to your eyes in response to the pain? That happened. It was definitely an eight on this
pain scale (props to
Hyperbole and a Half). I will never, in my life, forget how badly that hurt.
I believe I have a pretty high pain tolerance, but I'll be the first to admit that I take Tylenol or Advil when I have a headache before trying any of the other remedies (napping, drinking water, stopping caffeine intake). I don't like pain; I especially don't like seeing people in pain, so I'm all about relieving it in anyway shape or form. Unfortunately, there's not much they can do for a broken toe. Wrap it to the other supporting digits, and "try to stay off it."
Good luck with that. I was a college freshman walking to and from class, and I was on the dance team, which meant various bouts of pain ranging from "somewhat distressing" to "holy God
please cut off my toe" for the next few months.
When I was pregnant with my first child and had the "pain relief" discussion with various people, I remember being told numerous times how excruciatingly painful labor would be. It's worst, it's horrifying... "just get the epidural now" someone said. I had no doubt these women meant well, or that their experiences were painful, but somewhere in the far part of my brain I couldn't help but thinking "you end up with a baby, it's not superfluous, useless pain... can it really be
that bad?"
We receive numerous perceptions of labor pain from our friends, families, and the media. Unfortunately, our friends and families
also receive these
media images, and I have to wonder how much it affects how they viewed their pain, and subsequently how they interpreted it.
(it is right here that I launch into my birth stories, and if you feel this is about to become
TL:DR,
click here)
From reading, I understood pitocin can make labor contractions more painful, and a majority of these women who were telling me what Hell childbirth was had been induced or augmented with pitocin. But I still began to fret and worry. Would I be able to handle this? Can I do this? Forget the fact that when the baby is here, I'm going to be responsible for the moral and physical well-being of a human being, or how do I breastfeed, or what about the cost of everything... this, the pain of labor, is the epitome of fear right now.
Looking back - and maybe my view is skewed by the subsequent nine years of maturity and experience I've gained since then - I find myself questioning my own response and perception of labor pain. I remember laboring with my first, not entirely sure where I was at or how long it was going to go on, strapped with an IV in my arm and feeling like a nuisance for asking for the birthing ball, or asking to walk around. I remember worrying I wasn't responding "appropriately" to the pain I was feeling. Should it be worse? Is this the part where I'm supposed to start screaming? God bless my husband and sister for sticking with me, because we were all in the same boat... we'd done the research on what to expect, but not how to handle it, how to process what was happening, and what to do instead of panic. I didn't have to worry about pushing because he needed to get out, and by then I was relieved that I wouldn't have to deal with the pain of that. (Let's not go into the unknown pain of dealing with a c-section, that's another post).
With my second everything was different. I nested like a madwoman the morning I went into labor. I cleaned out everything - literally EVERYTHING - in my cupboards and fridge thinking I wasn't going to go into labor that day, or ever. Why would I? I wasn't dilated, barely effaced... the appointment was ticking down to my re-scheduled c-section, so I was almost resigned to the fact that my body didn't work properly. I should at least get ready for the baby by making sure the house is in "perfect condition" right?
Then, I went shopping. I was at Target when my belly started to tighten. Braxton-Hicks again ... *eye roll* ... BORING! Even though they were rhythmic and patterned, I didn't care. Whatever, I'm not in labor.
I was at Wal-Mart in the cereal aisle when I finally accepted it, but not until after I had one of those textbook contractions. The ones that take your breath away for a minute; the ones that everyone told you you'd finally get and then "you'll know" you're actually in labor. Rather than pain, I felt excitement and nervousness as I hightailed it out of there and back home. I called the doctor, expecting for some reason that they would either cheer, or react with shock at my announcement that I was in labor. But instead I received very calm instructions to take a shower, lie down, stay home for a while. All right, that's fine with me. I'm not that excited about being strapped to that IV again so let's do this here.
I showered, I paced the house, I organized a bag, I arranged for child #1 to stay the night with Grandma and Grandpa... the whole time contracting regularly, stopping to breathe if the tightening of my belly became too much, but handling it with what I considered to be amazing strength. Then, I decided to try laying down on the bed...
PAIN! PAINPAINPAINPAINPAIN! *struggles back to her feet* This is it, this is what they all talked about with the unbearable pain and torture. I can't do this, ohgodIcan'ttoomuchpainwhat... wait a minute... I'm contracting again... and it's not unbearable...
My mind tried to process my bodies response to standing vs. lying down. It was horrid a minute ago, well... maybe not horrid but more painful than this. I can handle this...
I laid back down and waited for another one. Same response: PAIN PAIN PAIN PAIN OH MY GOD PAIN!
It was at this point we left for the hospital, and I turned to my husband and started begging. "Don't let them make me lie down, please... please don't let them make me lie down. I don't want to lie down yet." He nodded, a little baffled and confused by my response.
In triage they told me I was 5 cm, and by the time they got me into a room I was at 7 cm. I hadn't been forced to lay on my back yet. They were hooking the IV into my arm while I was sitting on the very edge of the bed, upright and elated that I was ACTUALLY in labor, going for my VBAC, and so far it hadn't been horrible at all. I'm awesome!
Then the nurse said "You're at 7.5, if you want drugs you better take them now," as she tried to guide me into laying down on the bed.
My husband (who I still love dearly) didn't do anything. He didn't say "She doesn't want to lie down." Just looked at me, nervous and sheepish about "talking back" to the nurse. I laid back against the pillows, and rather than sitting right back up and asserting my right to stand or at least sit-up since I hadn't had any pain medicine yet... I panicked. I panicked because I knew what was coming. More contractions while laying down, then the unbearable pain of transition, of pushing, of being stuck on my back with my feet behind my head while the baby I loved so much traveled painfully down the birth canal and into the world. I panicked and begged for the drugs.
Looking back - more so now, but even after she was born - I questioned my perception and response to what happened. My epidural kicked in, and I'd laid in bed for the next six hours laboring... getting stuck at 9.5 cm for five of those six hours. I only fully reached 10 after my nurse checked me and said "Just start pushing, let's do this." I felt no pain, just lots of pressure... and lots of waiting while trying to sleep. I did feel pain during the delivery of the placenta, but that was after the epidural wore off, and they were pushing on my stomach. No one in the room at that time gave me ANY guidance or suggestions on how to handle that pain. In fact, they only time they addressed it was when I said "I'll push the baby out again, but you can take this thing by surgery... seriously... can you turn the epidural back up?" This, unfortunately, resulted in me not being able to walk again for more hours. Yay... I get to keep the catheter. Yay... I can't stretch after lying here for so long... yay...
I've asked myself again and again, not questioning anyone else's thoughts or perceptions of pain, just mine... was it really that bad? Did you need to beg, or if someone had been there to help you keep your sanity, could you have handled it? Had you not had the epidural, maybe she would have been born quicker? Would you would have been up and around sooner - or able to really sleep sooner? Maybe if you would have just stayed calmer you could have breathed through it... or Hell, screamed through it if necessary. How did you really feel about the pain?
Immediately, and I had done this with my first labor as well, I thought back to the broken toe.
That was gratuitous, unnecessary pain. There was no purpose, it just hurt. There was no logical reason for the pain other than my stupidity. My broken toe hurt, and was stupid and useless. And honestly, it hurt
WAY WORSE than labor... even when I was laying down and contracting. That pain wasn't as bad as the broken toe.
What about the placenta? When they were pushing on you?
Yeah, that hurt pretty bad... but
still not as bad as the toe. There was no purpose for the toe pain. Pushing on my uterus? They were getting the placenta out. The pain of contractions? That was getting my baby out. There was a purpose, it wasn't useless.
Then I made the list - which you
can read if interested - of times I've been in worse pain than when laboring. For me, it put
a lot of things in perspective; and as I've started talking to other women, encouraging them to make engaged, informed choices when it comes to their labors, I've
really begun analyzing the perception of pain.
I know numerous women who've been inducted, or augmented when their labor "slowed." Some inductions were medically necessary, some of them were at a doctors suggestion because she'd gone - in his/her opinion - "too far" past her due date; some of them were personal choices of an elective induction. Many of those who've elected induction admit pitocin contractions hurt worse than natural ones, but they've got the epidural on stand-by when it gets to be too much, and it's over when they want it over. Some complained about the long labor, the pain from induction, and they'd never do it again. Some said it was just easier to schedule a c-section. Everyone has an opinion on it, and they are completely willing to share it to any first or second time mother who will listen, many times not considering how it will affect her choices, or color her perception of labor pain.
Let's take a moment and address a few universal facts about pregnancy, childbirth, delivery and pain. First, everyone agree that at one point in your pregnancy - I don't care if you are the most holistic, natural woman on earth, or if you are the kind that wants an epidural the second the pink line shows up on the stick - at one point you thought "This sucks." Especially toward the end; around the 36-37th week.
You feel like you've swallowed a planet; you feel like a whale. You can't sleep well, you can't walk well, you can't sit down comfortably. You can't see your feet, let alone tie your shoes. Showering is an adventure due to balance, and let's not even talk about trying to shave. You might be swelling, you might have
PUPPS, you might be sick...
again. You may be the most positive person on Earth, and feel great 90% of the time, but I know at one point every woman who's ever been pregnant has said to herself "
Screw this, can it just be
over?"
If you're thinking "Not me, I loved
every minute,"... you are, in my opinion, a liar liar pants on fire. Not to me, but to yourself. Get over it; thinking the end of pregnancy (or any part of it) sucks doesn't make you a bad person/mother/holistic nature loving person... it makes you human.
But that above, that's just
YOU. Let's talk about the rest of the world and how they make pregnancy suck. The doctor checking you and saying
"You're not effaced at all" or
"Oh, look your 70% effaced and 2cm dilated," yet not telling you that this, in the end, means
NOTHING. The people you work with...
"Are you still pregnant?" "Haven't you had that baby yet?" "Oh, look how big you are!" (We're all guilty of it, even me. Sorry to all the pregnant women I've said that to.)
Your husband, God bless him... maybe he's clueless as to what to do. The
stupid house that won't clean itself; the laundry that keeps happening - Dear Lord,
WHY does it keep happening?
Who keeps wearing all these clothes?!?!
Last universal fact - labor hurts. Your uterus contracting, your cervix dilating... it hurts, there's no way around it. Pushing a baby out through your vagina? That hurts too. Delivering the placenta, breastfeeding, walking around, sitting, or trying to poop after delivery? Yes, it all hurts; there's no way around it.
You know what else hurts? A broken toe. A sliver. A paper cut. Lifting weights after you haven't exercised for a month. Running. Walking too long. A sprained ankle. A break-up. Watching someone you love in any kind of pain... I could go on, but you get my point.
The difference between labor pain and other pain is that labor pain has a purpose. It's natural; it's a part of life. It's
supposed to happen, it's how your body was designed to work. You aren't supposed to break your toe, or sprain your ankle. You should always work out, not take months off and then start up again. Your heart isn't supposed to break when someone leaves you, but hey... things happen. Labor pain has a purpose, it's your body's natural response to a natural event. It's useful; there isn't anything useful about the pain associated with a broken toe.
Labor pain is natural. It's not a medical condition; it's not abnormal, unless it's been augmented by hormones. Since it's natural and useful, maybe if you change your perception of it, you can handle it when given the proper guidance and support.
When I hear someone talk about their fear of labor, my heart aches for them. It's awful to be afraid of anything, but being afraid of an unavoidable event that you
want to happen... psychologically it feels counter-productive, which makes the fear, and guilt from fear, even worse.
My advice in the past has been to calm down, breathe, educate yourself and know that pain relief is
always an option if you need it. There's no shame in that at all. But I've also said to wait for it, to not get induced if you don't need to. I know, it's hard to be pregnant at the end, it's hard to be overdue... you want to meet the little person abusing your ribs and give them numerous kisses, you want to take them home... you want the pregnancy to be over. But be patient. Coming from the most impatient person on Earth (me), your body knows what to do and will do it when it and your baby are ready. Keep in touch with your doctors/midwife, and trust your body.
Now, that I'm aware they exist and what they can do, if I hear someone mention how afraid they are of labor and the pain, I say
find a Doula. Find a
group of them.
Find anyone who can help you keep your wits intact to deal with not only the pain, but the
fear of it. The more anxious you are, the more pain you will be in. Your spouse, your family, a doula, a best friend...
anyone other than the nurses (not because they aren't capable, because they're busy) who can help you stay sane will make the pain
so much easier to deal with.
We can't avoid pain while we're in our human bodies, it's impossible. But we
can control our response to it. We can control our
perception of it - and we are able influence how others perceive it.
If you are pregnant and reading this, or if you have been pregnant or ever will be pregnant, or KNOW someone who will be pregnant... before you start analyzing, or panicking, over how to handle the pain of childbirth, take a breath and step back. Think about the reasons for it, the process of birth, the miracle it is... and go from there. Don't think of pregnancy as a condition, think of it as a miracle with a purpose - yes, a painful one, but who said that miracles were pain-free? And who says it has to be the worst pain ever?
And ladies, gentlemen, doctors, nurses, media...
everyone... before you add your two cents to the pot about how horrible the pain of childbirth is, think about
what you want to pass on to the person you're speaking to. Do you want to frighten them? Scare them out of going through labor? Too late for that. Do you want to discourage them? Or do you want to
encourage them, offer them advice, and support their confidence rather than fear? There are too many other things in life that are pointlessly painful; let's not continue turning birth into one of those things.