I address the issue of pain in several ways during my classes. I have struggled with doing this—by mentioning pain do I plant the seed that their births will be painful? etc. I’ve eventually come to a place where I feel like it is important to mention pain directly and to look at it head-on. Many people have the perception that birth is THE most painful thing ever and essentially the most painful thing anyone could ever imagine. So, I feel like by not talking about pain in class, I would be ignoring the elephant in the room of THE (cultural) pinnacle of pain. While I have no doubt that birth can be very painful for some women, I deeply feel that our current birth culture and manner of treating birthing women makes birth painful for more of them.
A very useful tool in exploring sources of pain is the “Pain Pie” idea from Teaching Pregnancy & Birth: A Childbirth Educator’s Perspective by Marcy White (published by ICEA). With this tool, you create a red circle with the word pain on it and a separate set of white wedges (pie pieces) each containing a supportive element, such as “movement” or “relaxation techniques.” Each piece of pie covers up a portion of the red “pain”—as elements of the pie are removed, the pain piece gets bigger and bigger (an alternative presentation is to add pieces, so that the pain gets smaller).
I mention that too often women in our society are left feeling as if they “couldn’t do it” or that their bodies failed them, but in reality their coping pieces of the pie were stripped away from them (sometimes forcibly). I also talk about how sources of distress to the mother during labor: lack of emotional support, disrespect, ignoring of needs, repeatedly offering medications when none are desired, and restriction of movement, often have little to nothing to do with pain, but instead to what is happening around her (environment and caregivers).
Talk Birth 
I really like this game. Thanks for sharing it. It sounds VERY effective.
I, too, avoid using the word “pain” as much as possible. I use “intensity” and “pressure” most often, But, again like you, I feel strongly about speaking plainly about what is to come for women in labour: a continuum of intensity influenced by any number of factors.
It has actually given me a whole new framework for looking at birth stories–I “see” all the elements of the woman’s pie that were missing (or taken from her) and I have so much compassion for her “horror” story that way.
This is a great tool to see that there are tools to deal with pain and it is something to prepare for instead of be scared of!
Thanks for sharing this! It is a great tool! I also like the PAIN accronym. P-purposeful, A-anticipated, I-intermittent, N-normal
As far as using the word pain, I do at this time in my journey. I do because that is the term most women/people use for labor. i.e., the segment in Pregnant in America where they ask the folks on the street what labor is… So, for me, it seems that taking that term and breaking it down into tolerable pieces is important. Not denying what they perceive from stories and media, but putting it into context for them. That is why I think this pie activity would work well.
Pain in and of itself wasn’t addressed much in the Bradley class I took – directly. The focus was more on comfort measures, which is important too. I was glad though that I knew the physiology of birth, and I had seen natural childbirth before I attempted my HBAC. What I felt was – pain – in some sense of the word. But, knowing it was normal, and my body was working made me embrace it. In fact, I will be forever thankful for being respected and “allowed” to be with that “pain” for as long as I wanted. I could honestly say it was the highlight of my birth experience. I think it is all in our perception of what is happening. If we are set up to fail, then we will perceive these feelings as something being wrong, not our body and baby working toward an ultimate glorious goal.
Thanks for sharing this with us!
I use the PAIN acronym too, Kelli.