Search Results for: pain

Tuesday Tidbits: Pain, Birth, and Fear

20130903-200523.jpg  “…if you want to know where a woman’s true power lies, look to those primal experiences we’ve been taught to fear…the very same experiences the culture has taught us to distance ourselves from as much as possible, often by medicalizing them so that we are barely conscious of them anymore. Labor and birth rank right up there as experiences that put women in touch with their feminine power…” -Christiane Northrup

During my first pregnancy, I read like crazy. I felt like I was studying for the biggest test of my life, only it was impossible to know what was actually going to be on it. When I actually gave birth, I was delighted to find I was able to get out of my head and trust my body. Quite some time later, I figured out that information about birth does not equal knowledge about birth.

We spend a lot of time informing and educating women about their choices surrounding birth and are often then surprised that this apparent information does not translate into experience once in the birth room. Obviously, this is partially because the birth room is a context impacted by a large number of social, cultural, psychological, and environmental factors, but I believe it is also because with all of our information we still haven’t managed to help parents develop knowledge and the two are not the same. Parents are often not able to recall or to mobilize information resources while actually embroiled in the birth experience. They need an inner knowing and inner resources to draw on for coping.

via Information ≠ Knowledge

I also pondered (and continue to ponder) how women really learn about birth. Like I did, most of them seek out written information and this can lead to information overload…

With the wonderful world wide web available to us 24/7, the deluge of information we encounter (and seek out) during pregnancy can feel a lot like drowning. So many choices, so much to learn, so much to digest. There are times when everything seems to come into question — from what you eat during pregnancy to whether you should create a birth plan…

via Stop Birth Information Overload by Getting Back to Basics — Giving Birth with Confidence.

My all-time favorite article about the notion of this “information feeding frenzy” engaged in by pregnant women is by Pam England who explains the following:

It would seem at first glance that a mother who gathers lots of information during pregnancy is motivated and headed in the “right direction.” However, a more important detail of her preparation is her being aware of what is motivating her to August 2013 041become so well-informed. What does the drive for information feel like in her body? How does she know in her bones and gut how to use the information? And to what degree is she is aware of any of this?

If she is not listening to the subtle messages in her body, in her breath, in her dreams, or in the patterns in her thoughts and emotions, then she is acting from her conditioning and not from awareness. From the outside, no one may be able to tell the difference, but on the inside, she will feel the difference…

via Birthing From Within – Information Frenzy.

Which brings me back to this quote:

“I usually claim that pregnant women should not read books about pregnancy and birth. Their time is too precious. They should, rather, watch the moon and sing to their baby in the womb.” –Michel Odent

via How Do Women Really Learn About Birth?

And also to another of my own articles about information overload during pregnancy:

Many pregnant women have information overload. They are faced with more information than they know what to do with. They are bombarded by it. What they really need is “knowing.” They need to know: “What skills do I possess or can learn that will help me greet my birth with anticipation and confidence? What are my tools? My resources? Can I just let it happen?” As an educator I ask myself, “What will help them feel confident? Feel ready? Trust their bodies and their capacities?”

via Talk Less, Learn More: Evolving as an Educator

A lot of this information feeding frenzy, including that of my own first pregnancy, may be related to fear of labor, pain, and the unknown.

Could it be that human fear of pain is being used to generate financial profit? (the opium-is-the-opiate-of-the-masses model). Perhaps once the notion of palliative care reached a certain level of acceptance for the dying within the medical community, it began to spill over into other human conditions (the slippery-slope model). Or, perhaps we don’t want transparency at all (the denial model)…

…I can think of many questions that fall under this topic…Why do we call the intense phenomenon of birth “painful”? How do our genetics, behavior, training and thought-processes affect our experience of pain? What about the health care culture – has it focused on relieving pain at the expense of what we gain from working with pain short of trauma or imminent death? How do we prepare women for working with sensation without automatically labeling it pain? Is the “empowerment” often attributed to giving birth what is learned by going through the center of the “there is no birth of consciousness without pain” experience? These questions are just a start…

via About Pain and Birth | Dancing Thru Pregnancy® Blog.

Could these fears also be tied to our cultural lack of appropriate vocabulary for pain?

A childbirth educator interviewed during the film briefly discusses pain and says that we need more words for pain, because it is ridiculous that we have only one word that is used to describe a hangnail, a broken leg, being hit by a car, and labor. I had already been musing about pain during labor and how we perceive it, talk about it, and so forth and this comment was additional food for thought for me. I’m thinking that there are many other words used to describe women’s experiences of labor and birth other than pain–a word that is limited in scope and that for some women may well not even apply to the experiences in birth

via Words for Pain

Or, to a fear of “losing control” during labor?

A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful…”

via Fears About Birth and Losing Control

Or, perhaps more simply, to a lack of trust in our care providers?

I was interested to read a short segment in the book Labor Pain about studies on fear about birth. A Swedish study indicated that it was not pain that caused women the most anxiety about labor (44% of women had fear of pain). It also wasn’t fear of death of the mother or baby (55% worried about this). It wasn’t fear of their physical or mental capacity to give birth (65% feared this), but it was “lack of trust of obstetric staff during delivery” (73%).

via Fear & Birth

Men may also feel a lot of fear surrounding birth and have few ways to express it:

Although a man cannot feel the same pain as a laboring woman, I believe that many men experience a similar cycle of emotions in the birthing space to that which Dick-Read described, with a slightly different end product, namely: Fear > Tension > Panic. A man who is not confident in his partner’s birthing abilities, who is poorly informed, and/or who is poorly supported, becomes increasingly tense; and if this tension is not eased, then he spirals into an irreversible state of panic. This panic manifests differently in different men: some men become paralyzed by their fear (the familiar specter of the terrified dad sitting stock-still at the foot of the bed), while others spring into hyperactivity, bringing endless cups of water or becoming obsessively concerned with the temperature of the birth pool.

via Fathers, Fear, and Birth

I think it is also important to recognize the deep gifts to be found in facing our fears and doing it anyway:

We may feel guilty, ashamed, negative, and apologetic about our deepest “what ifs.” We worry that if we speak of them, they might come true. We worry that in voicing them, we might make homebirth or midwifery or whatever look bad. We don’t want to add any fuel to the fire of terror that already dominates the “mainstream” birth climate. And, we don’t want to lose “crunchy points.” We want to be blissfully empowered, confident, and courageous. And, guess what? We are. Sometimes that courage comes from looking the “what ifs” right in the eye. Sometimes it comes from living through them. My most powerful gift from my pregnancy with my daughter, my pregnancy-after-loss baby, was to watch myself feel the fear and do it anyway. I was brave. And, it changed me to learn that.

What if we can learn more from our shadows than we ever thought possible? There is power in thinking what if I can’t do this and then discovering that you CAN…

via What If…She’s Stronger than She Knows… | Talk Birth.


Tuesday Tidbits: Pain, Power, and Lasting Memory

Inspired by the Wednesday Wisdom series of posts at Pagan Families and because I’m teaching on Tuesdays this session and thus not able to type substantive posts, I’m planning to start doing a new short weekly post with a few quotes and birthy news items that have caught my eye. I’ve thought several times that I should do themed posts or posts on specific days about specific areas, but somehow I don’t really work like that and instead spend hours on long missives that are perhaps never read through to the end. I don’t really have a posting schedule or weekly plan for posting, it just…happens. I notice from my archives that I seem to regularly post about 16 posts a month. Maybe I do have a largely unconscious schedule that I follow…

So, here’s my tidbits for this week:

“A ‘no’ uttered from the deepest conviction is better and greater than a ‘yes’ merely uttered to please, or what is worse, to avoid trouble.” ~ Mahatma Gandhi

I should perhaps pin this to my head. I feel as if I’m constantly being offered wonderful opportunities (what a problem, eh?!) and must ever be mindful of, “choosing the best and leaving the rest.”

See also: Balanced Living and Saying ‘No’ and The Ongoing Crisis of Abundance.

Switching gears into birth and pain:

“Women experience pain differently; some feel strong overwhelming pain, some may feel a deep discomfort during birth, and still others may feel no pain at all. The experience of pain during childbirth facilitates an unfolding of inner power and resources we never imagined we possessed, similar to enduring the pain of completing a marathon at the finish line.”
–Barbara Nicholson and Lysa Parker, API founders

(Prior musings on pain and birth.)

And into the power of place:

“If we believe that birth is a powerful, sacred event that has personal significance and meaning for the mother, baby and family, then we need to recognize that where it takes place is a sacred and holy site.” –Jenny Hall, “The Sacred Place of Birth” (via Pagan Families)

In other news, the first digital-only issue of the Friends of Missouri Midwives newsletter is finally available online! Yay! I’m so excited. The theme is Birth Art.

On, I shared links to a couple of interesting articles:

Childbirth classes if you AREN’T interested in natural birth

Sex After (a Traumatic) Childbirth –

And, finally, I fell in love with this awesome quote:

“Birth sticks with a woman, remaining in her bones and her flesh as an embodied memory long after the baby has left her womb.”

– Pamela E. Klassen, in Blessed Events (via Pagan Families)

And, I used some of my new art (more about this soon) to make a little graphic with it too…


Pain with a Purpose?

“The desire to help is so great, even from well-meaning, beautiful midwives, that they use intervention. We want to help. But what’s missing in our culture is that there is pain with a purpose, and that helping is sometimes interfering.” –Augustine Colebrook, CPM (quoted in “Do-it-Yourself Birth” article in Mothering mag)

When I shared this quote on the CfM Facebook page, a reader added: “Dr. Bradley wrote about ‘pain with a purpose’…Problem is, in our society, we don’t value the process of childbirth. Therefore, whatever it is you have to do to get thru it… Hence epidurals & nubain, and on and on. Please know I’m not dismissing your experiences if you went that route. But that phrase alone resonated with me when I was giving birth and helped me. I wish it would do so with more women.”

I’ve written a lot about birth having inherent value in its own right. Process AND “product” (i.e. healthy mom, healthy baby) are both important. A de-emphasis on the birth process and its significance in a woman’s life only serves to disempower, silence, invalidate, and violate women.

That said, I do also value the work of organizations like Hypnobabies that questions the very notion of pain as being an inherent part of birth.

So, what about pain?

I find that couples who come to my classes often have pain and managing pain (or witnessing pain) as their top issue of concern. For this reason, I spend time addressing the subject straight out and yes, I have been known to use the dreaded “pain with a purpose” phrase. Some would say that the word “pain” has no place in birth classes—that it sets women up for just that experience—however, as I noted, my clients come with “pain” on their minds and I find I need to use the p-word and sort of clear the air/get past that hurdle, before we do the rest of our work together. Also, as one of my clients once noted, “it wasn’t you who planted that seed [of pain being possible]. It was planted deeply a long time ago!”

And, what would be the purpose of pain in labor?

It is actually part of a beautiful hormonal symphony of labor—the sensations of labor signal our brains to release more endorphins, more endorphins leads to more oxytocin, and more oxytocin leads to increased intensity, which leads to more endorphins, etc., etc. When the pain to brain feedback loop is interrupted with medications, so too, are the oxytocin and endorphin messages that we need to get our babies born—and more interventions to “augment” labor are then likely to follow. As Preparing For Birth notes: “It is true that naturally occurring labor can feel larger and greater than the woman birthing. This is not so as she creates from within the very hormones that increase the strength, power, and frequency of her work of labor. That is the good news, it is from her, for her, by her.”

But, all these things said, I simply think the word “pain” is woefully inadequate to describe the feelings of labor. I like this description from Stephanie Soderblom better:

“VITA MUTARI – the literal translation from Latin to English is ‘Life Transformation.’ That is the closest thing I could think of the feeling of labor/birth…what you are feeling isn’t pain, it’s life transformation. Is it dramatic? You bet! I think it should be!”

I also love the description from Painless Childbirth:

“When I say painless, please understand, I don’t mean you will not feel anything. What you will feel is a lot of pressure; you will feel the might of creation move through you. Pain, however, is associated with something gone wrong. Childbirth is a lot of hard work, and the sensations that accompany it are very strong, but there is nothing wrong with labor.”

Now that’s what I’m talking about, might of creation moving through you. The word “pain” is way too puny to hold that!

I always explain to my clients that the sensations of labor are more similar to the exertion of intense physical effort more than the pain associated with accident, illness, or injury—both the effort AND the exhilaration are similar to doing good, hard, challenging, limit-testing, but doable work (though even bigger and more important). We need a bigger and broader vocabulary for completely describing the breadth, range, intensity, and beauty of birth experiences! What if we had more choices other than “painful” and “painless” to describe the experiences of birthing our babies? Though I wouldn’t say my births were “painless,” when I describe my own birth experiences, “pain” is simply not the word that rises to the top as the most appropriate descriptor.

“So the question remains. Is childbirth painful? Yes. It can be, along with a thousand amazing sensations for which we have yet to find adequate language. Every Birth is different, and every woman’s experience and telling of her story will be unique.” –Marcie Macari

We end up limited when we use only “pain” based language that fails to embrace the broadness and complexity and enormity of the experience.

Newborn Alaina, January 2011

Pain Pie Exercise for Birth Classes

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).

Book Review: Painless Childbirth: An Empowering Journey Through Pregnancy and Birth

Book Review: Painless Childbirth: An Empowering Journey Through Pregnancy and Birth

By Giuditta Tornetta
Cumberland House, 2008
ISBN 978-1-58182-640-1
320 pages, softcover, $16.95

Reviewed by Molly Remer, MSW, CCCE

Written by a mother of two who is also a doula, childbirth educator, hypnotherapist, Painless Childbirth takes the pregnant mother on a physical, mental, and spiritual journey from conception through postpartum. The text is interspersed with personal stories from the author’s own pregnancies and births as well as those of her doula clients.

A lot of people are initially skeptical of the phrase “painless childbirth” and I really loved the author’s description of what painless childbirth means: “When I say painless, please understand, I don’t mean you will not feel anything. What you will feel is a lot of pressure; you will feel the might of creation move through you. Pain, however, is associated with something gone wrong. Childbirth is a lot of hard work, and the sensations that accompany it are very strong, but there is nothing wrong with labor.” The book has no rigid concept of what “painless” means and no suggestion that mothers who do not experience birth as painless have “failed.” Painless Childbirth is written in a gently nurturing tone throughout (you can “hear” the author’s doula skills coming through), but is also very assertive that painless childbirth is very reasonable, doable, and is, indeed, the birthing mother’s right.

The book contains a lot of ideas and concepts that are of use to doulas and childbirth educators. I particularly liked Tornetta’s characterization of the three phases of first stage labor according to the primary means of coping with each phase—distraction, concentration, and surrender.

After my own experiences with pregnancy loss, I have become more aware of the treatment of the subject in birth books. Painless Childbirth directly addresses childbearing losses in a short, but compassionately written segment about healing past grief. The book also has content about exploring and overcoming fears.

The book is holistic in its approach, addressing body, mind, and spirit. It contains a lot of spiritual content of a “new age” flavor (for example, lots of references to the law of attraction and the book is organized by month according to fetal development as well as associated body chakra). While I definitely agree that birth is a spiritual event, my practical, down-to-earth side stumbled a bit over some of the concepts and phrasing, and the esoteric content may not appeal to all audiences. That said, Painless Childbirth presents a positive, loving, welcoming approach to giving birth that is both refreshing and interesting.

Disclosure: I received a complimentary copy of this book for review purposes.

Perceptions of Pain

Some time ago I wrote several posts about pain in labor, one of which addressed needing more words for pain. In the book Birthwork, there is an interesting list of possible perceptions of pain in labor:

‘Satisfying painenjoyable labour

–‘Positive pain’–it is birthing the baby

‘Constructive pain’–it is doing a good job

‘Functional pain’–acceptance of the process

‘Okay pain’–it hurts but everything is on track

‘Intense pain’–it is a lot!

–‘Abnormal pain’–something is not right

‘Overwhelming pain’–unable to manage alone (exacerbated by isolation, fear, exhaustion, and tension).

‘Off the wall pain’–utterly unbearable (usually associated with intense nerve or spinal pressure).

Even though these aren’t new words for pain, I think they add to our vocabulary for describing what is going on with our birthings. Additionally, keep in mind that you can transform the language and perception of the sensations of labor even further, by not using the word pain or contractions at all–you can refer to “sensations” or “tightenings” or “pressure” or “waves” or “surges” or “intensity” and so forth.

Pain, Power, & Accomplishment

I love this section from Giving Birth with Confidence (Lamaze). It explores the role of pain in labor and its relationship to personal power and accomplishment:

The pain of labor, like most pain, is protective. Responding to pain with movement, including walking, rocking, and position changes, not only helps the baby rotate and descend through the pelvis, but also protects a woman’s body during the process. As the cervix stretches and dilates, oxytocin levels increase, and contractions strengthen and become more effective. As pain increases, endorphins are released that help women cope with the demands of the stronger contraction and the descent of the baby. Actively responding to the pain..then not only promotes comfort but promotes the progress of labor…Because the pain of labor is not associated with trauma, but is a part of a normal, physiologic process, it is sometimes compared to the pain associated with other challenging physical activities. Those who push themselves to climb the last hill, cross the finish line, or conquer a challenging dance routine often report feelings of euphoria and increased self-esteem. Researchers have found that women who experience natural birth often describe similar feelings of exaltation and increased self-esteem. These feelings of accomplishment, confidence, and strength have the potential to transform women’s lives. In many cultures, the runner who completes a long race is admired, but it is not acknowledged that laboring women may experience the same life-altering feelings. [Birth classes] help each woman find ways to meet the challenges of birth confidently and purposefully, and to discover her strength in birth.

The above explains very well why it is that I do what I do–I want each woman to have the chance to experience that transforming power, that sense of personal accomplishment, the increased self-esteem, and the euphoria of knowing “I did it!” I climbed my mountain, I ran my marathon…I gave birth to MY BABY!

Fear-Tension-Pain or Excitement-Power-Progress?

I love re-framing traditional concepts of birthing to more positive and empowering perspectives. Recently, I was reading an older issue of the International Journal of Childbirth Education and came across a concept that I immediately loved and will incorporate into my birth classes from now on. Most  childbirth educators are familiar with the Fear-Tension-Pain cycle–wherein fear raises tension in the body which leads to pain and so on. Reducing one element in the cycle leads to reductions in the others–i.e. reducing tension through relaxation techniques leads to less pain and then less fear.

While this is still a very useful concept and I will continue to use it, the new perspective I just read about was the Excitement-Power-Progress cycle. The idea being that labor can be greeted with excitement and welcome instead of fear and anxiety. As the power of birth grows, so does the progress towards meeting your baby! So, you can greet the increased power with excitement and confidence and know that your body is making beautiful progress.

The author of the article I was reading (Stacey Scarborough), phrased it like this:

“Fear = EXCITEMENT about being labor and having a baby!

Tension = POWER, strength, or energy!


Pain-Free Birth?

As I’ve referenced before, I have a special interest different theories with regard to pain and birth. The last issue of the Midwifery Today e-news had “Pain in Childbirth” as a theme and there was an excerpt of an article by Ingrid Bauer called “Pain Free Birth?” It was very powerful. She says:

“Inevitably, in discussions about unassisted or natural birth, the topic of pain-free birth rolls around. When it does, I wonder if striving for a ‘pain-free birth’ doesn’t inadvertently miss the potential beauty of natural birth itself. I don’t believe birth is meant to be pain-free, in fact, I believe it’s far more than that! I believe, and have experienced, birth to be downright ecstatically, blissfully pleasurable. ‘Pain-free’ doesn’t even come close to describing that experience. That’s like calling a high sexual union with your mate ‘pain-free,’ or the most breathtaking sunset you’ve ever seen ‘ugly-free.’ I think that as long we’re focusing on getting rid of or avoiding pain, we’re focusing on the wrong area and we’re completely missing the point.”

I love this! Language is so powerful. I like how Hypnobabies educators often refer to “easy, comfortable birthing” and other people who refer to birth as “pleasurable birth” or “joyful birth” or “ecstatic birth.” How much more descriptive than “pain-free” or “painless” that is. Painless or pain-free to me communicates a loss of sensation or awareness–a “deadness” or “dullness” to the fullness of birth.

Movement and pain

A brief quote from Biance Lepori an Italian architect who specializes in the design of birth rooms:

“Even pain dissolves with movement; pain killers are a consequence of stillness.” (emphasis mine)

This architect specifically designs rooms that support physiological birth–birth that unfolds accords to the natural biological processes of the woman, on her own timeline, and under her own power.

I emphasize active, normal (physiological) birth in my classes. I feel like the use of movement is one of the single most important ways we have to embrace labor and its rhythms and also to support healthy, physiological birth. Though I teach a variety of positions for labor and birth, “birthing room” yoga poses, and encourage practicing them, I believe that the movements you need during labor come from within and arise spontaneously during labor, not from specific training and practice. The key is the FREEDOM to use movement in the way you need to (many women end up being denied the right to free movement during labor 😦 ). The benefit to practicing different positions and movements prior to birth is that you gain a “body memory” of how to move your body in labor supporting ways.