Childbirth Emotional Preparation

Why do some women sail through the pain of labor without a hitch, and some are seemingly unable to have an unmedicated birth even when that’s what they want for themselves?

I have pondered this question for many years. I have attended hundreds of unmedicated births and I have stood on the sidelines and seen women that make birth look easy, coping with the pain of labor like a champ, and other births where the woman gives up, or seems like she caves in on herself with each contraction. Why? What is different for one woman versus the other?

Over time science has identified the hormone oxytocin as the cause in the onset of labor, and how it keeps labor going. If the flow of oxytocin is interrupted, labor slows, or even stops. This happens frequently when leaving the safety of home for the bright lights, unabated questions, strangers, and chaotic atmosphere at the hospital. Suddenly a woman that had contractions 5mn apart, has her rushes space out to 15-20mn, when admitted to the hospital. Certainly the atmosphere makes a difference. Her own cozy, darkened room, with little to no talking in low tones is going to feel a lot safer than bright lights, standard hospital decor, and a steady flow of conversation all around her is going to cause stress, rather than safety and relaxation will halt labor for some, and other women take it in stride without a pause, why?

We don’t want to over simplify the “why”, and of course there are many reasons involved, not just one, but there’s a reason that’s often overlooked. Could the answer lie with the meaning we give to the pain itself? I have found that there are 3 main meanings we give to pain. 1) Physical pain means: “I didn’t deserve it” 2) Physical pain means: “I deserve it” 3) Physical pain has no meaning, it’s just a sensation. Can you see how the meaning given #1, and #2 would lead to feeling unsafe and avoidant of the pain? Believing that the physical pain of labor feels like emotional pain, is something that a woman would avoid if she has made a habit of avoiding her painful emotions because she equates one sensation with the other and it makes her feel unsafe. A common question that doulas and midwives will ask is: What are you afraid of regarding your labor and birth? Do you have any fears that we haven’t talked about? Frequently the answer will be:”I’m afraid of the pain.”

Says that she is afraid of the pain seems self explanatory because no one WANTS to experience pain in any situation, including labor, and so the focus then shifts to positive affirmations, and pain coping strategies, but the reason for the fear of pain is never uncovered, or dealt with, and so the mother accepts an epidural even though she was determined not to accept any pain medication. Unfortunately it becomes a self-fulfilling prophecy because deep down inside her fear was telling her all along that she couldn’t do it. It isn’t true, but if she believes it, it becomes her reality. After the birth she may feel guilt, shame, worthlessness, and then adds all of this to her list of reasons why she can’t cope with pain in the future.

As a first time mom, I was afraid of the pain like many other women. I didn’t know it at the time, but looking back I realize that I was deeply afraid of emotional pain. Most women don’t know that any unresolved trauma, or emotions, are likely to come to the surface during labor and birth, another reason why it is such a vulnerable experience that shouldn’t be shared with just anyone. It’s an experience that requires the woman to be surrounded by love, safety, nurturing, compassion, and understanding. How can you be supremely vulnerable, physically, emotionally, psychologically, and feel safe in an unfamiliar environment? It ain’t easy! I personally chose to have a homebirth because I felt that it was the best, and safest place to give birth. I am so grateful to my midwives book list because I read a midwifery manual written by Rahima Baldwin and she shared a thought that stuck with me through my labor. The idea was that pain is just a sensation, it has no meaning, in the context of labor in particular. The common view of pain is that it indicates harm, or danger of harm. When you feel heat, you may jerk your hand away and yelp in pain even though it didn’t actually hurt, because you associate heat with potential pain and harm. Notice the reaction is to withdraw, or avoid, and in that situation it’s useful and beneficial to avoid the heat to protect yourself from pain and damage, but in the context of labor and birth the pain is a good thing, not harmful, or something to be avoided. Why is it a “good” thing? Because it leads to a cascade of hormones for mom and baby that lead to a healthy birth and postpartum experience. Because it helps the cervix dilate so that the baby can be born. Because you’re going to get to meet the precious little human being you’ve been carrying around for nine months! Notice what your body does with those thoughts, maybe you sigh, maybe your shoulders relax, maybe you smile…that’s oxytocin baby!

In hindsight, I realized that when I experienced pain I would feel sorry for myself, like a victim of the pain. The little girl inside of me felt that I was being unjustly punished for something I didn’t do. I made the decision to make my birth mantra: “Pain is just a sensation.” That choice was life changing! From that point forward in my life I no longer equated physical pain with emotional pain because it became a mental loop - if I can handle physical pain, then I can handle emotional pain. Once I saw the truth about pain, I couldn't “unsee” it. I felt like I was on top of the world after the birth of my first child even though I felt pretty rough physically because I faced my fear, and was victorious. Being able to birth a baby seemed like a real super power that no one ever told me about, and convinced me that all women should start motherhood that way because being a mother (a good one) is very challenging and you need to draw strength from your past accomplishments, and for me birth was the hardest marathon of mental/emotional/physical endurance that I had ever taken on. Recently, the second meaning we give to pain came to my awareness when pondering over the many births I have attended and the things women have said regarding their experience.

The second meaning we give to pain is: “I deserved it”. This is the flip side of the first one: “I don’t deserve this”. This is also an emotional meaning given to pain, but it’s based on the little girl's belief that pain is punishment for wrong behavior. In this case she believes the “punishment” of labor is deserved, but she doesn’t want to be viewed by others as deserving of punishment because that would make her feel ashamed for having done something “wrong”. What rotten way to begin labor! These meanings we give to pain are unconscious, and not limited to women, but they show up in labor as fear of pain. When these fears are unearthed, and assimilated, they no longer have such a death grip on the mother and it’s possible for her to have the full experience of her birth without internal hindrance. Ultimately the choice to deal with emotional and physical pain, or to avoid it, is a personal choice and each woman makes the one she feels capable of making at that point in her life.

As a woman that transitioned from the idea that pain means: “I don’t deserve it”, to the belief that pain (physical or emotional) is transient and has no meaning unless I give it meaning: I can honestly say that it is empowering, and has made me so much stronger, I feel capable, courageous, like a leader instead of a follower, I feel unstoppable all because I change the meaning of pain. From now on, instead of asking my clients what they fear about labor and birth, I will ask: “What does pain mean to you?"