fear and pain in childbirth


I wrote in my Mama Natural birth story write-up that I'd advise a woman to "eliminate the word pain from your vocabulary" as she approaches her birth.

I'm rethinking that now. Because there may be pain. For the vast majority of births that's probably true. And while it's not helpful to DWELL on the pain, and in fact some of the most helpful labor techniques are those which move attention elsewhere, it's not something we'll usually skip over entirely.

I wouldn't describe my last two births as painful. Not up until the very end. The fact that that is my experience has been surprising to me. I remember clearly the first time I met a mama who informed me ahead of time that she was expecting to have a pain-free birth. She explained that she had been praying very specifically and with expectation not to have pain, and that she had confidence based on her understanding of the Bible that Jesus would bear that pain instead of her. Frankly, I thought she was nutty. I wasn't even sure that it was an admirable goal because  (and I still believe this) pain can be a worthy way of sacrificing, of dying to the old self so that you can be re-born as a mother, a mother willing to reorient her life and her self around her babies so that they can thrive in the world. Pain can be redemptive, symbolic, it can bring us to places we wouldn't otherwise ever get to. Pain can be a rite of passage, and on the other side of it we discover we are capable of much more than we had ever dared to imagine. That's the sort of suffering that the Christian faith calls us to in Jesus.

So why were my last two births not painful? Unlike my past photography client, I did not pray for that, did not go in expecting it to be painless. But what I did do was find a way to approach birth without fear. It comes from having witnessed so many births that were characterized by power, love, joy, freedom and lack of intervention and emergencies. As natural physiological birth begins to replace old images and paradigms of births fraught with screaming and resentment, drama and emergency, fear just starts to dissipate. You can also choose to cooperate with that, by actively resisting fear. As fears rise up in your consciousness, you pick it up and take a hard look at it, then you work through it however is appropriate. In some cases, dealing with fear will mean processing it by talking it out with a trusted midwife/doula/friend or journaling about it until something clicks and it loses its power. Sometimes dealing with fear will mean coming up with a plan to deal with whatever specific aspect/outcome you're dreading so that you feel prepared and safe. And in a more general sense, we can shrink fear by filling our imaginations with images and feelings and stories of births that were not fearful. Working to clear out fear ahead of time, we can actually significantly reduce pain. There's a complicated and very real physiology behind this. I've linked to a great article about at the bottom of this blog post.

I'm reading a book called Giving Birth: A Journey into the World of Mothers and Midwives by Catherine Taylor. There's a small section in there about the idea of pain as compared to suffering or affliction, and I want to quote that here. This excerpt begins with her describing a section of a doula training course she attended with Pam England (author of Birthing From Within)...

Pam winds up the day by telling us that she wants us to spend some time thinking about the distinction between pain and suffering. “You can experience every sensation, even pain, and not suffer,” she says. “Start trying to make that distinction for yourself, and then you can make it for your others.” I remember that another nurse-midwife once told me, “The whole concept of suffering is something that should not be in a birth vocabulary. Pain does not equal suffering. Suffering is when you have no hope, when there is no end in sight. That’s torture, that’s suffering. But the pain of childbirth has an end point, so there is hope and there is pain, but it doesn’t have to equal suffering.”

Adrienne Rich, in her book Of Woman Born, says that French writer Simone Weil made a similar distinction, although she said that suffering was “characterized by pain yet leading to growth and enlightenment,” whereas “affliction is the condition of the oppressed, the slave, the concentration-camp victim forced to work endlessly and to no purpose.” Weil stressed that affliction occurred where pain was associated with powerlessness and disconnectedness. When pain was inevitable, it could be ”transformed into something usable, something which takes us beyond the limits of experience itself into a further grasp of the essentials of life and the possibilities within us.” I start to consider the distinctions among pain, suffering, and affliction and find my lingering dread about my own upcoming labor begins to shift.

This is so good, and so important. This is perhaps a big piece of the work of midwives and doulas and childbirth educators: that we help women to make peace with -- to even befriend -- fear and pain so that they can glean the gifts it has to offer them.

Maybe what I'd say now, instead of "eliminate the word pain from your vocabulary" is something more like "eliminate fear" or "remember that pain does not equal suffering or affliction; and even suffering can be purposeful."

For more on the subject of pain and childbirth:

  • Why Labor Hurts - an amazing piece about the physiology of fear and pain and how that impacts a birth process. I highly recommend giving it a read-through.
  • Soul Labor - I haven't read anything but an excerpt from this book yet, but the author deals with the role of childbirth pain in the journey of Christian faith
  • Reducing Fear of Birth in US Culture -- a TEDx talk by Ina May Gaskin