Pain Happens, Suffering Doesn’t Need To

There’s a lovely article out right now: “Denying the Pain of Labour Is Like Denying the Pain of Life”. In it she talks about how “pain-free birth” has become a holy grail, even among people going for a ‘natural’ birth. If you just do XYZ, your birth will be painless, or orgasmic, or some other enlightened, empowering phrase. And for the women who don’t find that enlightenment, even if they do XYZ, there’s feelings of disappointment or failure.

The flip side of this is the people who look at the suggestion that pain is inevitable in labor, and think how HORRIBLE and CRUEL it is to make a woman go through such misery. This viewpoint is especially prevalent in some feminist circles, who find the idea of experiencing pain in childbirth as a barbaric throwback to the days when easing pain in childbirth was actually illegal because of the “punishment of Eve”. It also occurs in traditional care provider circles because they have been taught that pain is the enemy, something to be defeated.

But what they are talking about, what they and every single birth professional, be they in home, hospital or birth center, is rightly against is not pain, but suffering.

Suffering is when the experience of pain overwhelms us, when we start telling ourselves negative stories about what the experience is, when our coping skills are overwhelmed. We have, all of us, experienced pain without suffering. How many of us have cut ourselves shaving, and it didn’t start hurting until we saw the blood? Or the bruise on some body part that you discover later, but you have no idea when or how it happened? It’s a bruise, pain signals from the damaged area had to go from there to the brain, but you weren’t aware of them. What about smacking your thumb with a hammer? The ‘coping skills’ people use for that (yelling swearing, hopping up and down, grabbing the affected hand) are so common, they’re used in cartoon and comedy. We’ve gotten through broken bones, bruised shins, cuts, bumps, scrapes, scraps and other painful mayhem by drawing on our own, inborn coping skills, and our body’s natural response to pain.

Take, for example, getting a tattoo. It hurts, right? Getting little needles poked into your skin at high speed is not going to be without pain. And yet people do it all the time, sometimes in amazingly intense hours-long sessions. How? If you watch someone getting a tattoo, you often see the same coping skills that women use in labor; deep or naturally patterned breathing, eyes closed inward focus or eyes focused on a specific point, external distractions. And if you talk to someone after a tattoo, they may describe feeling “euphoric” or “floaty” or even “orgasmic”. That’s because they were able to use their body’s natural response to pain,endorphins, to get through.

Or what about a marathon runner? Labor is often compared to marathon running- lots of hard physical work, ups and downs and breaks, and an exhausting but exhilarating finish. No one denies that marathon runners go through physical pain when running, and yet, no one suggest that they should take medication at the soonest opportunity, or that they are suffering for ‘no reason’ or are ‘trying to be a hero” or just out to ‘win a medal’. In fact, their perseverance, focus and drive are often lauded and celebrated.

So how do those runners get through their marathons without suffering? Training and education. They’ve done things to help their body prepare physically for the marathon, they know how their body is going to respond to the challenges of the event, and they’ve learned skills that will help them meet each challenge as it comes. And they, too, rely on endorphins to get up and over the pain.

Fear leads to Suffering

Quotes from Master Yoda aside, one thing both the tattooee and the marathoner have been able to do is overcome fear. Remember when we talked about all the things that have caused pain, but we’ve not noticed them or ignored them or powered through? Part of the reason we coped with those experiences is because we were not afraid.

When we experience fear (even when we know we are ‘safe’, like watching a horror movie), our body floods us with hormones that get is ready to either run like heck, or put up a fight. And those hormones override endorphins, because if we’re going to be running or fighting, we need to not be loopy on natural painkillers.

In labor, that Fight or Flight response directly interferes with the birth process (In a whole lot of complex ways, that’s a complete blog post of its own!) and increases pain. Increased pain when someone is experiencing fear, increases the fear, increasing the pain, until the coping skills are overwhelmed, and suffering sets in.

So a key element to childbirth preparation is learning how to recognize and face potential fear triggers in labor, learning what your own reflexive, already existing coping skills and resources are, and learning to draw on those coping skills at any point during labor.

By educating women about labor and birth, by validating their concerns and helping them recognize their coping skills and resources, by giving them tools to respond to the pain of labor without fear, by giving them skilled support in labor (and not expecting partners to be professional Coaches, and allowing partners to be supported in what is their birth, too!), we set women up for experiencing labor and birth without suffering.

Through giving all birthing women these resources we make it so that, if or when medical supports become a part of birth, or a woman reaches a point where she feels she’s tapped out her coping skills and requests medication, she’s done so in complete awareness of her body and her choices, and she can make decisions without doubt or fear of ‘failure’.