This definition invokes fear. It does not embody a belief that pain or sensory feedback is designed to be worked with, that pain can have a purpose in birth, and that a laboring mother can move through it and embrace it as feedback.
Giving birth is a biological function, an event that women's bodies have been designed for. It is my experience that fear of pain is something that hinders many mothers in birth. Through my years of experience as a birth doula I have found that there are 3 sources of pain a laboring mother may experience.
Emotional pain is the fear of the unknown. It often is directly due to a lack of education. Fear is primitive, causing muscles to tense releasing a rapid production of stress-inducing hormones. As the hormones cortisol and noradrenaline are released, a laboring mother’s heart rate and blood pressure will increase and her muscles will tense. Her sensory focus will narrow increasing resistance to the experience; she will lose her ability to reason. Her emotions will become all inclusive and monopolize all her functions. Survival is hardwired. For a first time mother, the concept that surrendering into the contractions makes them easier to work with is counter intuitive. By witnessing birth, talking with other experienced women and through education a mother can understand the birthing process better and the emotions that go with it. As a mother prepares for her birth, her feelings of control and security increase as her fear of the unknown disappears.
In labor, it can be critical to have someone with the laboring woman who is emotionally connected to her and is not afraid to ask, "What is your biggest fear right now?" This person can be her partner, mother, sister, friend, or doula. They should be ready to help her process her fear productively. For example, some women will even joke in labor about their fears. Taking a few minutes to address a laboring mother’s fear can help her reduce emotional pain.
Physiological pain is directly due to the contractions, the decent of the baby, the position the mother is in or the procedures she is exposed to. It is the partner’s goal to keep the mother as relaxed as possible and avoid any unnecessary interventions that may cause pain. There are a few simple but effective reminders that a partner can give to help support the mother during this time.
* Remind her to take deep diaphragmatic breathes so she can get the most oxygen to her muscles and her baby.
* Consider changing her position every 30 minutes or so unless she is relaxed, or appears to be meditating or sleeping.
* Remind her to use upright positions whenever possible to work with gravity. When laboring mothers are upright they find the contractions are typically closer together but shorter in duration and therefore more manageable. Gravity can also help to align the baby in the pelvis.
* Suggest side lying positions for comfort or for resting when alternated with upright positions.
* Pay close attention to clenching of the mother’s jaw, hands or feet. Clenching or grasping movements may slow decent of the baby or cause pain.
* Help to keep the mother relaxed. Most mothers make the most progress in labor when they are kept relaxed "like a wet noodle."
* Remind the laboring woman to drink water and electrolyte drinks. Fluid intake plays a critical role in preventing dehydration and a dysfunctional labor pattern.
* Remind the laboring woman to use the restroom. Voiding hourly helps to makes space for the baby to descend and makes contractions less intense.
Functional pain is additional pressure with or without contractions due to derivations in labor. Often times this is from a misaligned mother or baby. Many misalignments can be avoided or corrected in pregnancy with proper care. Basic childbirth exercises to strengthen birthing muscles will help to align a baby early. Walking, swimming and sitting upright with a straight back are all easy to do throughout pregnancy and have long lasting rewards for mom and baby. Chiropractic care and acupuncture can help to open the mother’s body and allow a baby to find the right way out. Homeopathy can be an amazing choice for the mother in labor as well. Having a trained birth worker at a birth can guide mom and her partner through a variety of positions as well as use advanced techniques like rebozo to help with alignment and to speed the process.
When dealing with pain in labor, it is important to remember that most women will want pain relief with contractions. But when the contraction is over she can relax, gather her energy and prepare for the next contraction. The partner’s job is to assist the mother through both the pleasures and pressures of birth, not to ‘fix’ the labor or birthing experience.
Pain is finite. Pain has a beginning and an end. It will not last forever. In labor it may be very hard to surrender to the process; but many of the discomforts of birth can be dealt with by having a good support team and a provider and birth place that will work with your choices. Most emotional pain can be avoided with preparation including comprehensive childbirth classes like those offered by Informed Beginnings educators. Functional pain can also be alleviated or avoided with proper care and attention to details. However physiological pain in labor is part of the natural process working hand-in-hand with a natural endorphin release. This combination of endorphins and hormones is complex and wonderful. When the mother feels safe and supported the labor process can unfold as needed and transforms women into mothers.
This experience can empower you for the rest of your life. Welcome it and let birth transform you.
Informed Beginnings welcomes this guest post by Ursula Sabia Sukinik. Ursula is an Informed Beginnings educator and doula, and owns Birth You Desire in Bethesda, Maryland.