Pain and Pleasure?

Enjoy

Have you listened to the podcast The Longest Shortest Time? Episode #28, The Missing Chapter to Ina May’s Guide is so worth the listen. Please pop over there and do yourself a favor – then come back to me here. The interviewer, Hilary speaks to Ina May Gaskin – yes, the Ina May Gaskin, the grandmother of the natural birth movement, and basically tells her how she felt betrayed by both her and the NBM when her birth ended up not being at all what she expected after reading all the “right” books and doing all the “right” preparation for what she hoped would be an “ecstatic experience.”

I might be in the minority on this one, but I think it’s totally okay to say to pregnant women, “Birth is probably going to be painful.” Now what level of pain a woman experiences during her birth depends on tons of different things: Is she tired and hungry going into labor? Has she taken a class that’s really emphasized how to cope with contractions? Are there a lot of tried and true tools coming into the labor and delivery unit with her? Is she feeling confident or fearful of the birth process? What’s her labor support team look like? What’s her personal pain threshold? Is her birth slow and steady, or fast and furious?

There’s lots of extenuating factors that will have an impact on her ability to cope with contractions and manage them effectively without any pain medication. There are some women who really feel that the pain of labor and delivery is negligible! One of my students actually said, “I’ve had paper cuts that were harder to deal with!” In my experience, she is the exception to the rule. But having a painful birth doesn’t mean it has to be a negative experience.

When I hear that a woman felt like her birth was not painful, I’m thrilled! And so is the woman who’s telling me her birth story! But she’s happily surprised by this turn of events. In my classes, women are prepared to work hard through contractions and know they will most likely experience some level of pain and discomfort as they’re going through labor.

I don’t ever want a woman to be angry and disappointed that she actually had pain with her contractions. I want her to have realistic expectations that birth, for most women, is painful. I don’t emphasize that point, and I don’t dwell on it, but I think they should be prepared.

If they have the expectation that there will probably be pain in their labor – no matter how well they breathed with their partner in the classroom, no matter how often they change positions, no matter how they’re using the “doula’s epidural” of getting in and out of the tub for pain relief – then a laboring woman can work with her pain and not be overcome by it. Rather than making pain the star of the show, she can give it a minor supporting role and move on. Maybe this will allow her to actually enjoy the experience of giving birth.

It might seem like I’m talking out of both sides of my mouth.

“Birth is going to be painful.”

“Birth is something you can enjoy.”

But I think both statements are true. I try and have my couples imagine something that they’ve done, a physical challenge of some sort, that was painful to get through, but still left them feeling positive, happy, satisfied, proud of themselves, and accomplished once it was over. Then I’ll ask them, “At any point, did you feel like you were suffering?” If they feel it was a positive experience, the answer will almost always be “No.” If I press and ask if it was painful,  they might respond with – “It was one of the most painful things I’ve ever gone through – but it was so worth it!”

They would not be able to respond this way had they experienced suffering. It’s so important to make that distinction between pain and suffering. They’re two very different things. Pain is something we feel, suffering is our overwhelming and negative perception of that pain.

No woman should ever suffer through her birth. If she ever reaches the line that separates pain from suffering, then we’d better be doing everything we can to keep her on the side of continued coping. If she has crossed that line and moved into suffering, then we need to do something immediately or she can be traumatized by this experience – even if it goes according to her “natural birth” plan.

What about the woman who hopes for an unmedicated birth, but goes into the experience thinking, “If the pain gets to be too much, if I think an epidural has become medically necessary, I’ll ask for some relief.” She may not end up needing this relief. But identifying a tool to help her if she’s beginning to suffer is what counts here. An epidural as a medically necessary choice allows her to care for herself during birth without feeling like she somehow failed, like she wasn’t strong enough to get through without drugs.

More than anything, I want women to enjoy their births so that they are able to move into parenting from a place of peace and confidence, feeling proud and accomplished by what they’ve just done. I might sound like a broken record, but a birthing woman – despite mode of delivery – has co-created a new human being, grown her baby in the perfect environment and then on the day of birth, she either opens and pushes her baby through her body into this world, or she goes through major abdominal surgery to bring her baby into this world. She has already done an amazing job. She has already done more than enough.

Feeling guilty about needing to use interventions like medication or surgical delivery to birth her baby has no place in the postpartum experience. When a woman is feeling betrayed by her body, by the medical establishment, by the natural birth movement, she cannot fully enjoy her experience of pregnancy, birth or new parenting. There’s not enough room for enjoyment – there is only room for anger, blame, and shame. How does this benefit a woman in her new identity as mother? How does this benefit the couples relationship?

I think it’s entirely possible for a woman to enjoy birth, no matter what the circumstances, but we need to provide the birthing woman with realistic expectations about labor and delivery first. We need to encourage her to find her voice and participate fully in the experience. She needs to surround herself with the right people as members of her support team. And then she needs to be prepared to make the hard choices that weren’t a part of the original plan if they become necessary. In this way, she might experience pain, but she can also enjoy the pleasure of giving birth.

When you gave birth were their moments of pain? How were you able to tolerate the pain? Did you enjoy giving birth? What made that possible for you?

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