Episode 21: Pain in Labor

In this week's video I'm musing about pain in labor.

An unpopular facts in the "natural" birth community: The experience of pain in labor is primarily influenced by two things: 1) the position of the baby and 2) the pelvis that genetics graced the birthing person with.
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Yes, mindset shifts can reduce suffering ten-fold. Yes, relaxing through contractions reduces pain. Yes, hydrotherapy, moving regularly, staying upright, lots of labor support with counter pressure, etc. etc.. can help decrease pain.

But the primary factors influencing one's experience of pain in labor are things birthing people can't do much about. (Sidenote: You CAN do your best prenatally to encourage your baby into optimal positioning via prenatal movement, and I do cover this in a body balancing prenatal yoga session in in the Brave Journey Birth Preparation Program -- but even after doing your best with regular prenatal body balancing, your baby may still be in a less than optimal position which may make labor more difficult and painful.)

There is no one right way to give birth. There is no one right way to experience and respond to the intense sensations of birth. And we can keep this in mind if we find ourselves feeling either pride or shame about our experience and/or response to pain.

Full Transcript:

Hello, and welcome to episode 21 of the Brave Journey Free Weekly Birth Prep Videos. I like to show up and talk about whatever's on my mind about birth or postpartum. And this week, I am thinking a lot about pain versus suffering. So that's what we're going to talk about today.

Now I'm coming at you back here in my backyard next to a waterfall, and I'm hoping that it is a soothing sound. But it might also be a really distracting sound and I'm sorry. So in the future, if it's too distracting, let me know and I won't do it again, but I personally love coming out here to, uh, think and talk to you. And it's finally cooling off here in Phoenix, Arizona for me to be back here in my backyard next to one of my favorite plants in my backyard.

So pain versus suffering. First off, I want to be very clear: I'm using the word pain. You may hear some doulas and childbirth educators refer to the sensations of labor as intensity... They may refer to contractions as surges or waves. And while it is absolutely true that when a contraction is building, it feels like a wave that builds builds, builds, builds, peaks and then goes away over the course of 30 seconds to a minute. You are not feeling that intensity the entire time during labor. It does ebb and flow. So that's helpful. But I think to not call the sensations of labor pain is to do a disservice when we're trying to help people prepare for birth.

I think there are two different kinds of birthers. There are people who are preparing to birth, who are terrified, who think that they are going to be in the worst pain they've ever been in their entire life and, uh, are going to do everything they can to avoid the intensity of that pain, which is wrong- they're, they're not necessarily going to be in the worst pain they've ever been in their entire life. And there are some people who are approaching birth way over confident. They've been told they can achieve achieve. I hate that term around birth. They've been told they can do something to do it "right". And achieve a pain-free birth or a peaceful birth, and they are completely unprepared for the transformational intensity that is birth. That is includes some pain, but also includes just so much more mental, physical, uh, um, a need for stamina and courage and strength of the like fortitude sort like the, the personality fortitude that it requires to get. No matter whether you're birthing unmedicated or pharmacologic with pharmacological pain relief or via cesarean birth is intense.

And so when people go into it, thinking that if they do it right, they'll just have this pain, pain-free peaceful birth, where they just like puff and breathe their baby out - That could be doing a disservice for them. We really never know what labor is going to be like for us.

It depends on two things.

One our own internal anatomy, the shape of our pelvis. How close our clitoris is to our vaginal canal and how close our lower back is to our vaginal canal and all of those things that are just, how are we are built.

And the position of the baby. And some things can be done prenatally to help position your baby optimally.

And I do absolutely teach those in the Brave Journey Birth Preparation Program,, but there's no guarantee. And there's no guarantee that if you do all the "right" things, that your infant is going to magically be born with an optimal fetal position. Um, you do the best you can, but you just, aren't going to know.

So the positioning of your baby affects the sensations of labor and how painful labor is. And your own internal anatomy, which it just is what it is. Everybody is built different in their pelvis, the dimensions and the how close things are and how you're going to feel where the nerves are and the way the baby is placed.

Some people claim they have orgasms during birth. I don't mean claim like that doesn't happen. It does happen, but it's like less than 1% of people. And it probably just has to do with how close the nerves of their clutter is, are to the rest of their vaginal canal. And it's how they were built. Born. Everybody is built different in their pelvis.

Our pelvic anatomy is super complex, super diverse and super fantastic, but you just never know what you're going to come into it with.

So I use the word pain because I want people prepared for intensity. I want people prepared to work hard and I don't want them surprised when it is a mind-blowingly intense experience.

I've also had births I've attended where I was in awe of the strength and courage of the person, the person birthing. They were roaring their baby out. They were moaning, but afterwards they were embarrassed because they made noise. And I felt so bad for them to have been embarrassed for roaring their baby out.

So now every time I talk to people about preparing for birth, I like to invite the fact that you may roar your baby out. And that is 100% awesome. And it is really connecting with the strength and courage and bravery it takes to walk the journey of birth, which is why I named this, this wonderful business of mine, Brave Journey.

So let's talk about pain versus suffering for a second. So that was a little bit about why I use the word pain and some of my thoughts about pain.

And pain versus suffering. So pain is usually an indicator. Pam England has a wonderful quote. I should have it exactly right, but I don't have it in front of me, but it's something like:

"pain may be an inevitable part of labor, but much can be done to ease suffering". And this is absolutely true. The pain of labor does not have to equal suffering. And this is a nuance that I love to talk about. Oh, my favorite plant has given me a little kiss. This is something that I love to talk about and think about, but when you're in pain, because you have an injury, your body is saying "there is something very wrong with the situation and you need to attend to me so you don't injure me further". That's pain and that can include suffering. Labor is not the pain of suffering. Labor is the pain of labor is not because anything is wrong. In fact, the more intense and painful contractions are sometimes the more effective they are in moving that baby, helping that cervix open the baby, rotate and move down versus like really gentle and easy contraction sometimes are not effective contractions.

And. There's always somebody who, who has like super easy gentle contractions and their baby like falls out in a beautiful, easy way. So we're not all the same. And our experiences of birth are not all the same. And even at the same birthing person with multiple babies are not going to have the same experience with the different babies.

And I can say that from my experience, my first birth versus my second birth were wildly different for a few different reasons. But one being that I had two very different infants in my womb that I needed to birth vaginally. And, um, the first one was about eight and a half pounds and the second was about 11 and a half pounds.

And, um, it was different. I'm just going to be real with you. It was the two experiences were very, very different and the sensations were very, very different. So suffering is when something is wrong. And it also involves the story that we're telling ourselves about the pain.

So if we can say yes to the intensity. Yes to the strength of that contraction. Yes, because this is, everything is right. And this is bringing my baby down versus blaming or shaming ourselves for making noise and labor or feeling angry about the situation that we're in or worrying that we're not doing it right. Or worrying that we can't do it. Versus just being in the moment and welcoming the intensity and working through it.

Also pain is a wonderful indicator to the body to start moving, to find different positions. Often the best advice for birthing people is to labor in positions that feel good because the positions that feel most good tend to be the ones that are most beneficial for that stage of your labor.

No, not always. There's always complications for some folks whose baby is less than optimally positioned you may have to take on a few uncomfortable positions for a few contractions to try to help that baby turn.

But generally, if you move in ways that feel good, the pain is a wonderful indicator to your body to move out of one position that isn't helpful and to move in another position, which isn't so painful and to labor through the next 5 contractions in that next position.

So pain can be really, really helpful. Pain is saying the pain and labor of saying pay attention. Something huge is happening and you need to find a safe place to birth this baby. You need to find a place where you feel safe, where you feel private, where you can move and moan and make noises in ways that feel good for you.

And that reduced the pain of these sensations. Um, and so therefore you can have pain and labor, but not suffering. And that's a difficult nuance. And I know that maybe this, maybe some of you are watching this I'm a match. I wish we could have like a live conversation about this because I'm sure some people are like what the actual, you know, what she talking.

But these are some of my thoughts. I've seen it in action. I've experienced it in different ways. I've only had, I've only given birth twice and that's only a sample of two, so it's not enough to tell you what to do. And that's another thing that really bugs me. And I'm just going to be real blunt right now.

This is my last point. Is that people who want to promise you a pain-free birth, I think that they are unethical. I think that it is damaging. It is potentially damaging birthing people when they try to promise a pain free birth. Do some people have a pain-free birth? Absolutely. Is it because they just relaxed enough and they managed to have a pain-free birth or an orgasmic birth?

No, it had to do, like I said, in the beginning with their anatomy and with positioning of their baby. Is there much that we can do to help get that baby into optimal, fetal positioning? Yes. Can we guarantee it? No. Can you guarantee that you'll do all the right things to get your infant in the perfect position?

No, you can try your best, but you cannot guarantee it. And the reason I think it's unethical to promise people a pain free birth it's because they make people think that if they just didn't relax enough or they didn't do the right things, that they did it wrong. And nobody needs to be told there is any right or wrong way to birth their baby, because that is absolutely not true.

Absolutely not true.

There is no one right way to birth your baby. None. Okay. So that is all I want to say about pain and pain versus suffering. Um, I have many, many, many more thoughts on this, but I tried to organize myself enough that I wasn't just rambling at you.

So let me know what you think.

Did you experience pain and labor?

Did you have a pain free birth?

That's it for episode 21, I am hard at work recording the full Brave Journey Birth Preparation Program. I have 31 lessons to record. And I am, I have done like 15, no, maybe like 10 to 12.

Anyways. I'm super proud of myself because they are coming together and I'm really happy with how they're looking. And I think they're going to be really helpful and have a really positive impact on birthing people. So you're going to be hearing a lot more about this once I release them because after I finish them now, I'm then I'm going to need people to take the class.

So anyways, I will close this up. Thank you. I appreciate you. Email me [email protected]. If you have any questions, um, let's talk. Have a great day. Bye.