Pain: A Necessary Part of Birth? - a podcast by Sara Pixton

In this episode, I tackle the topic of pain during labor and childbirth.

REFERENCES:

Chooi C. S. L., Nerlekar R., Raju R., Cyna A. M. (2011). The effects of positive or negative words when assessing postoperative pain. Anaesthesia and Intensive Care 39(1), 101-106.

Dick-Read, G. (1984). Childbirth without fear. New York, NY: HarperCollins Publishers.

Mongan, M. (1992). HypnoBirthing: The Mongan method. Deerfield Beach, Florida: Heath Communications.

 

TRANSCRIPT:

Before we get started today, I just wanted to give a shout out to the social media group Birth Words Community. If you are not a part of it yet, head over to Facebook and type in birth towards community and request to join the group. And come join us as we have conversations about the importance of the way that we speak about pregnancy and birth and the postpartum period. So head over to facebook and join us in the birth words community group.

 

Hello, welcome to today's episode. Okay, so… many people think birth and think pain. Oh, I'm so excited. I'm pregnant but I can't stand the thought of the pain of giving birth. Even my husband, after I’d become a doula and had a very empowering birth experience. I said, “I needed help thinking of an affirmation. Do you have one?” And he said, “pain is babies leaving the body,” which was humorous and funny and whatever. But still it associates pain and childbirth as almost intertwined and inseparable, and as the defining characteristic of childbirth. I don't think this is the way that it needs to be. Let's get talking about what is going on here.

So I'm going to use as the basis for our conversation, an article written by Chooi, Nerlekar, and Cyna. You can see the show notes for the citation, but it's called, “The Effects of Positive or Negative Words When Assessing Post-Operative Pain.” Now, this is an interesting article with interesting implications. It's a different context, and it can't be totally applied to our situation, but… food for thought.

So this article was written, aimed at an audience of anesthesiologists, and it was raises some important questions about how birthgivers frame their own experience and how they're cared for. And in this article, they conducted a study to determine the effect of language when checking in with post-cesarean patients. So the assessors came into the room of the recovering patients the first day after their cesarean. To half of the patients, the assessors said, “Do you have any pain at the moment?” And they asked that to 116 patients, and 63 of them--54%--responded that they did. To the other group, they used more positive language, asking, “How are you feeling? Are you comfortable at the moment?” Again, they're still checking in on their physical well-being, but not introducing the word pain into the argument. So in this group, only 28 of the 116 women—which was 24%--reported that they were in pain. And they were recovering from a major surgery, so… interesting.

So for the most part, this study was well conducted. It did have some limitations that the authors acknowledged. Only the patients, not the assessors, were blinded. And there's a difficult-to-define spectrum of pain and comfort, and that affects the results. And I'm not claiming that this was a perfect study. But again, like I said, food for thought in the care of laboring women.

So, imagine a similar phenomenon that might happen to someone who's giving birth. If asked how she's feeling or if she's comfortable. The birthgiver and her support and care providers can work with her to find optimal comfort and to find a rhythm with the work that her body's doing. If she's confronted with the question, “Are you in pain?” Or, if she's been anticipating pain since the day she first learned that the stork isn't the source of all babies… Then what's she going to experience? She's gonna likely fall into what we call the fear-tension-pain cycle. And this was really purported by Grantly Dick-Read, an influential British obstetrician and the author of Childbirth Without Fear. He was a proponent of natural, painless birth during the 1930s. And he hypothesized that pain in childbirth comes because of fear, which causes physical tension, which leads to pain. And he inspired the Hypnobirthing founder, Marie Mongan, and others.

So I have not experienced a painless birth. I have talked with some who have. And I do feel that what I identified as pain during labor had a different function than pain I've experienced at other times, and that the pain I experienced in during labor did not color my experience and it doesn't really register in my memory of it.

So back to this article about the post-operative pain assessing. The authors point out that during pregnancy in the postpartum period, women are increasingly susceptible to the power of suggestion, which is acutely true during labor, so we need to carefully consider how our language frames the birth experience. And I'm saying this for those supporting birth givers. I'm saying this if you are currently pregnant, how are you framing the experience that you're going to have for yourself? And is pain playing too big of a role? How can we work with that, figure out where that's coming from, and reframe it in a way that's going to help us have a more healthy and empowered birthing experience?

So I certainly do not want to discredit women who have experienced pain during childbirth. Like I said, I am one of them. And although I believe that there are ways to manage pain, there are ways to increase comfort in labor, I feel that it would also be beneficial to reframe our perception of pain in labor.

I do believe that there are ways to manage pain and increase comfort in labor. Hire a doula if you don't have one, and she will let you know all the tricks: counter pressure, different positions... I tell you what, lying in a hospital bed is pretty much the way, especially if you're on your back… best way to maximize pain during labor! But moving around, making noises, listening to music that helps you calm and release that tension, being with loved ones who make you feel safe, being told that you're doing such a beautiful job working with your body, getting some nice hip squeezes and lower back rubs, other forms of counter pressure and love and support… that will make a difference in your level of comfort during labor.

Also, considering reframing our perception of pain and labor is important. And this is something that really needs to be done prenatally because it involves some work that can't be done on the same day while you're in labor. So as the author of the study, the authors of the study point out pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Or Google says, “physical suffering or discomfort caused by illness or injury.” Again, some of that could happen during birth, especially in certain situations, but a lot of that is just not relevant. This is an illness. Is this an injury? Is this an indication that something is wrong in my body? If I break my leg, I get stung by a bee, my body sends pain signals to my brain saying, hey, something is wrong, get this checked out. Sometimes, that is the meaning of pain in labor. If baby's mouth position or if you're not in the best position, and it's saying, Hey, let’s try to get in a different place, try something different, to help this be more comfortable for everybody involved.

 

Sometimes though, what we call pain in labor is the intensity of a contraction. And it's often a sign that everything is right, that the body is doing just what it needs to do in order to birth this baby. So for this reason, hypnobirthers have chosen to linguistically reframe many of the sensations of labor. They call contractions waves or surges, which again works for some and not for others. These words are inspired by images of nature running its right in proper course and they can help you in labor realize that your body to is doing what it naturally should. Many hypnobirthers speak of intense pressure rather than pain as that's how they experience the sensation of the uterus working to open and then the cervix. My friend Joanie, who talked to us in Episode 6 (check it out if you haven't yet!) used pressure to discuss The sensations that she felt of labor. And yes, it was intense pressure. But she felt that that was more fitting than using the word pain to describe it.

Here's my theory, our minds work with language. That's kind of how we make sense of the world by putting it into words, especially if you're linguistically-minded. And so we look for a term to make sense of our experience, and we choose one from common experience. But did you hear that? We choose one from common experience. Birth is anything but common experience! So I argue that this term, which again, may feel like the right term to use for some people, but it's a term adopted from common experience, to describe this very uncommon experience, and I think that there's a bit of a misfit there.

Many women feel that hypnobirthing isn't for them or this approach doesn't work for them and they say, “I feel pain during labor,” and again, I felt pain during the labor. And when you say you're in pain, those supporting you should believe you and work to help manage it. But if you are laboring along, and you maybe said uncomfortable, or “Oh, this is intense,” you haven't said anything of pain, then let's not introduce the word into the vocabulary of the birthing experience. Let's talk about optimizing comfort. Let's compliment you for beautifully handing handling the intensity of the experience and let's remember your body knows what to do and you are doing just what you need to be doing.

So, to close, whether or not pain is part of your birth giving experience, it does not need to be the defining characteristic.

 

Did words play an important role in your birth experience? If you're interested in sharing your story on the podcast, go to www dot birth words. com. If you're liking what you hear on the podcast, please leave a review on your podcast app. For more resources about harnessing the power of words to benefit the birth experience, visit birthwords.com

 

Transcribed by https://otter.ai

Further episodes of Birth Words: Language For a Better Birth

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