Probably at the top of the list, along with tearing and giving birth by cesarean, is the fear around pain in childbirth. This is perfectly natural — at the most basic level, pain whether emotional or physical, is generally a message to our brain to respond to something that is impacting our well-being. It makes complete sense from a very instinctive, primordial level, to be afraid of pain.
Yet, labor pain is unique. When you are in labor and are experiencing pain, the pain is not telling you that something is wrong — as a matter of fact, increasing pain generally is telling you that everything is right, that your labor is progressing! Pain in labor is productive as it helps with the production of oxytocin (the labor hormone that produces contractions) and endorphins and those hormones have a positive feedback relationship to one another meaning the more you have of one, the more you have of the other. So what this means is that when it comes to pain in childbirth, we need to look at pain in a different way.
What is interesting to me about pain, is that paradoxically, pain keeps us safe from harm. For example, it is because we feel pain that we remove our hand from a hot pan, preventing us from experiencing further damage. Congenital analgesia is a condition where people are incapable of feeling pain, and these people generally have shortened life-spans and very high rates of injury. Pain keeps us from further emotional harm too. It might lead us to leave a friendship that is not healthy, or to make changes to our lives that are helpful. Pema Chodron, a Buddhist monk, talks about ‘making friends with the pain’. Basically, how might pain be helping us in this moment?
One of the most useful approaches we can take in shifting our perception of pain is to be able to recognize the difference between pain and suffering. Pain is a stimulus, no more and no less. Period. Potential suffering, however, comes from what we tell ourselves about the pain AND what we tell ourselves about ourselves when we are experiencing pain. It is possible to experience pain and not suffer. It is also true that what we tell ourselves not only can cause suffering but also increases our pain. So, when we are in a suffering mindset in labor, we experience more pain, both physical and emotional.
In labor, what do I mean when I talk about emotional pain? It is frequently the case that when we start to investigate our fear of pain, what we fear even more than the pain is our RESPONSE to the pain. From a very young age, we grow up with messages about what are okay and not okay responses to pain. For example, some of us grow up with messages that we need to be stoic and pretend nothing is wrong; others learn that we shouldn’t ask for help when we are in pain. We receive hundreds of these kinds of messages throughout our lives. As social beings who require connection and belonging for survival, ( this is literally the case when we are children) we listen to these messages and strive to follow them because to not follow them can mean rejection and isolation. So it is often the case in childbirth that what is feared is the pain yes, but it is also how we will respond to the pain. When we respond to the pain in a way that goes against our belief system of what is okay, we experience emotional pain and we suffer.
Here are some tips to help prepare you for the intensity of birth prenatally:
- Explore your beliefs assumptions about pain and pain coping; Pam England, in her new book Ancient Map for Modern Birth, suggests asking yourself the following questions:
- What is okay to do when you are in pain?
- What are others supposed to do when you are in pain?
- Is there anything you are telling yourself that you should not or cannot do in order to ‘do it right’ or be proud later?
- Imagine yourself doing it. How does it feel? How might it help?
- To whom would this response be unacceptable? Is your belief influenced by someone important to you?
- If you acted this way in labor, what do you think it would imply about you?
- What would you say to another woman who coped with pain in this way?
2) When you experience discomfort in your day whether emotional or physical, pay attention to where your mind wants to take you. Do you tend to blame others? Tell yourself affirmations? Get in a “No…..not again mindset”, or go inwards and shut the world out? Which of these responses are helpful? Which seem to increase the pain? Try not to judge, but just notice. Practice more of what you found helpful.
3) Try being curious about discomfort when you experience it. Where is the centre of it? Where is the edge of it? What is the sensation like? Warm, cold, pulsing radiating? Can you make ‘friends with the discomfort?’ Maybe it even has a message for you,like to change positions, or to stop or slow down what you are doing. In the case of emotional discomfort, maybe it is trying to point you to a deeper need, like to connect with a friend, or to ask for a hug.
4) Practice mindfulness. Spend some time every day quieting your mind. Many people find turning into their own breath and just noticing the coming and going of their breath, without trying to change their breath in any way, helpful. When we quiet the mind, we quiet the part of the mind that gets into the suffering mindset leaving us to experience sensations without necessarily suffering from them. If you practice doing this prenatally, this will be easier to do in labor.
5) Do something that challenges you, something that requires endurance either physical (if safe to do so depending on how your pregnancy is going) or mental.Where does your mind take you when you find yourself getting frustrated or overwhelmed? When you want to stop, what do you tell yourself to keep going? What do you find helpful when you hit that wall that helps you keep going even when every part of you wants to stop?
6) Practice turning towards others, asking for help and receiving help. Even in pregnancy, you may already be noticing that there are some activities that you are finding more challenging to do, or are incapable of doing. You may have already begun asking for help and experienced the discomfort and/or relief that comes from reaching out and the discomfort and/or relief that comes from not reaching out. For almost all there will come a time in your labor when you need to reach out to what is greater than yourself, and turn towards someone for help and receive it. When we take the opportunity to explore the difficulties and judgments we have about asking for and receiving help in pregnancy, asking for and receiving help in labor (and in parenting) will be easier.
7) Exercise! One study, cited in Ancient Map for Modern Birth, showed that pregnant women who exercised three times a week for thirty minutes maintained higher endorphin levels during labor and reported less pain than women who were sedentary during pregnancy.