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Wednesday, November 15, 2006

Some thoughts about a four-letter word

PAIN.

I hesitate to even write this post, because it gives pain a privileged position in childbirth. We all know how pain and birth are talked about: birth as the most excruciating pain a woman will ever endure, pain management in labor (a euphemism for drugs), getting a pain-free labor with hypnosis...

But now that I have been there done that, I feel the need to share my experience of pain. Not because it was awful or excruciating, but because it was one of many, many sensations that made up the entirety of labor.

Before my labor began, even before I became pregnant, I knew that I wanted to experience labor in its fullness. I wanted to feel every sensation, pleasant or not. I firmly believed—and still do—that by numbing myself to the painful parts of labor, I would also miss out on the bliss and the ecstasy as well. I wouldn’t be pain-free by taking drugs or having anesthesia; I would be sensation-free. I didn’t like that idea.

I wasn’t wedded to the idea that labor had to feel a certain way. I didn’t expect pain, but I also didn’t expect its absence. Honestly, I expected to feel a great many sensations as I labored, and I knew that pain might be one of them. I loved reading stories of painless births, ones that take a woman by surprise because she doesn’t realize she is in labor, or the ones where a woman experiences bliss and waves of pleasure. I listened to Marie Mongan’s Hypnobirthing CD and read her book. The CD was incredibly useful for relaxation during pregnancy and helping me sleep when nothing else could, but I resisted her assertion that if you relax the right way, you will not feel pain. I think that often is the case, but I didn’t want to be so dogmatic about my own labor and feel that I somehow failed if I experienced a sensation as painful.

My contractions felt like sharp, intense menstrual cramps, all entirely in the front of my abdomen close to my pubic bone. I can only say they were “like” menstrual cramps because cramps for me don’t come and go like contractions—they are a slow, dull, relentless ache, almost in my pelvic bones. The contractions became more intense and more painful as labor progressed. Pushing brought on a different kind of pain. I think the ferocity of the contractions and the uncontrollable urge to push made the sensations a bit more difficult to integrate. All I had to do during the labor contractions was relax and let everything happen, keeping my body totally loose. During pushing, however, I HAD to actively participate even though I sometimes didn’t want to, because it was so intense.

The funny thing about pain is that it fills any given space. It’s like a gas—no matter how small the amount, it will completely fill the volume it occupies. That’s why I hesitate to say something like “it was the worst pain I have ever felt.” Heck, even a paper cut, at the moment it happens, can be the worst pain ever!

The pain I felt in labor was clean and finite: as soon as it was over, it was over. Completely gone. I calculate that I spent far more time feeling pleasure during the rest periods, than I did feeling pain during the contractions. Except for a few short moments when I became discouraged during pushing, I never felt like I was suffering or in distress. Just very focused on the task ahead of me.

A few times during my labor, I was able to alter the sensations from being painful to pleasurable. During the early morning hours while I was leaning over the kitchen countertop and breathing deeply, I started smiling and making my face look blissful. Another time, soon before I started pushing, I said to myself mentally, “breathe in comfort, breathe in relaxation” (a phrase from the Hypnobirthing CDs). Both times, the pain altered itself instantly into a rushing kind of pleasure, kind of like the dizzy tingly feeling you get before you faint.

One of the best ways I have found to approach labor pain is with this acronym:

Progress
Anticipated
Intermittent
Normal

Labor pain indicates that your body is working. You know it will come and then it will disappear completely (unless you are having back labor because of a posterior presentation, but that is another story). It is not a signal that anything is injured; instead, it comes from muscles working incredibly hard and from tissues stretching and expanding—as they are meant to do.

Pain was one of many sensations I felt during labor. It was strong when it was present, but it did not dominate the experience. Almost all of the time I was able to integrate it without judgment. Instead of thinking oh no this hurts, I am suffering, make it stop, I was able to think this way: another contraction, the pain is building, inhale, exhale, sway my hips, the pain is ending, now I can rest. I had awareness of pain without labeling it as good or bad. It just was.

11 comments:

  1. Rixa,

    I found this post to be fascinating, because I have experienced both ends of the spectrum. It was amazing to read how I felt expressed in your words.

    With my first birth, I went into it expecting to be able to relax the pain away. I wasn't able to. Between the induction and the intensity of transition, I was completely swept away with the pain. IT HURT!!!! I wanted to quit. I wanted to be done. I was so grateful when it didn't hurt any more. I was so glad to push him out of my body because it hurt so much.

    Then there was the birth of my third child. The labor was intense. I had to breathe through the contractions. I had to sway my hips, get on my hands and knees, relax as thoroughly as I could. However, it didn't hurt. I never even broke a sweat. As a matter of fact, he came so fast that I emotionally was not ready for him yet. I fully expected to go several more hours. I almost felt like I had missed out on part of the experience because it came so fast. But it didn't hurt. It was wonderful and incredible. Once again, I was swept away, but this time it was with ecstasy and a feeling of intense power gushing through my body. It was amazing!

    I think the difference between the two was a shift in my expectations, and a learned ability to deal with the sensations. In the first one, I interpreted all the sensations as pain, when in actuality, most of them probably were not. By the third one, I was able to revel in the experience, and feel everything as it really was. It was empowering and incredible.

    I have learned something new with each one. With the first, I learned about pain. With the second, I learned I could handle it. With the third, I learned to revel in it. What a difference that makes!

    I am really excited to get pregnant again, and experience labor for the fourth time. I actually am excited and looking forward to the labor because I know how incredible it really is.

    I once had a friend tell me that after she had her first baby, she felt like she could do it again the next day. After I had my first, I thought she was crazy. Now I truly understand where she was coming from.

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  2. Yeah, I felt like I could do it again the next day--except my bottom was really sore and I didn't want anything coming out of there for a while!

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  3. i fell victim, after my first (natural, painful, hospital) birth, to the idea that it was my fault i felt pain-- i joined the UC list to be honest and was told that i wasnt relaxed enough in labor and that must have been why it hurt.

    when my 2nd came i had a midwife attended homebirth and was hopeful i could relax enough for a painless birth. this was silly. it was long and drawn out (27hrs) and i believe that was mostly due to the feelings of failure i had, because it was still painful. of course ther ewere other factors, like the audience.

    i had a UC a month ago. the pain was there but i had grown during my pregnancy to expect nothing in particular. i had a feeling it would hurt somewhat, based on past experience, but i also knew it was its own birth and i could not label it. the one thing i was certain of in pregnancy was that i could handle anything the birth had in store for me.

    it was fast, and healthy, and absolutely wonderful. it hurt, yes, it hurt sometimes a lot. but there was pleasure in there, just like you describe. the breaks between contractions seemed so long, i always had enough rest to be ready again. and i know just what you mean about the tingly before fainting sensations. in my birth story i tried to describe this, i think i used the word exhilaration.

    as my son was born i experienced a critical mix of pain, exhaustion, exhilaration, and loss of control that i believe brought me into the motherhood of anatoly. this initiation is necessary: emotionally, physically, hormonally- would i ever leave him? grow tired of nursing him through the long night? abandon my duty of this child? never.

    tabitha (not karl) o'melay

    my blog is xanga.com/omelay

    it is private but if you want to join you are welcome. i just dont want you to think i am a weirdo!

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  4. tabitha and kelley, both of your comments were wonderful to read. It's so hard to talk about pain because it has such a strong negative connotation in our culture. Yes, my labor pain hurt, but it was no more than that.

    tabitha, I am going to read your blog right now! I see you have your birth story up.

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  5. Yeah, having BEEN THERE, DONE THAT Rixa-- isn't it glorious? I don't mean bragging rights... not the badge "they" are so fond of saying no one will give you if you refuse your epidural... Oh no, of course it's all entirely between you and your God. Precisely because like you said, it wasn't about merely conquering any pain, but trusting the whole experience. To allow whatever may come into your internal story of who you are, a story now so much more complete!

    Because now you know! No wondering and second guessing what this birth could have been like; it was exactly what it was meant to be.

    Again, I'm really happy for you :)

    Judit

    P.S. Endorphins = pain, shmain.

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  6. So glad to have read this before going into labor. It's easy sometimes to trick yourself into certain expectations and ways of thinking. Having had one birth experience already that was definitely less than satisfying I was all set to deny certain aspects of it in favor of thinking this next birth would be perfect and pain free. Not on a totally concious level of course, but still, the mind has a way of forgetting previous events, especially the bad ones. Thanks for bringing me back into reality a little bit. I do feel very ready, now I just have to wait for baby to agree.

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  7. Hi Rixa,

    I have just spent the last little while reading through all your archives. Very, very interesting. Since I heard from your mom that Zari was born, and since my sister-in-law Candice is planning a natural birth (in hospital, I think), I have been thinking more about it. What I thought before reading your blog was that it would be very empowering. It seems to have been that way with you.

    I'm glad Zari's here and that everything worked out well. How does Zack like Zari?

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  8. Zeke learned very quickly that Zari was NOT a toy or an animal. He was a little confused with her the first few days, especially when she cried. He'd look at us all confused, like "fix it!" Now he is adjusted and gives her an affectionate lick every so often.

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  9. Beautiful. I will have to remember that mantra when it comes time for me to give birth again (in the very distant future, I assure you!)

    -Jill

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  10. I've been going through your unassisted birth posts because I'm considering one for our next child. I keep wavering between UC or having a midwife in the house- somewhere else, but in the house. It's a tough decision.

    Your experience of labor reminded a lot of my own. I nearly had a UC because my labor was not nearly as bad as I expected, and I labored at home until I could feel her head crowning! I don't think that labor would have been that "easy" if I had been in the hospital, or even if my husband had been awake for most of it. The pain felt like cramps to me also, and was rather sharp, but didn't last long. Maybe 45 seconds at the longest? Pushing was really an incredible experience.
    I can say, like you, that I immediately thought that I could do it again, and that I wanted to! My friends thought I was crazy. Thanks for these posts.

    What was it that made you go with a midwife for Dio?

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  11. [Note much of this comment is reposted from a previous comment on the "what does giving birth feel like" post.]
    I had four planned home births, two of which (the first and the last) ended up being surprise unassisted births. I experienced my first birth as much more painful than the others. I labored on my knees, leaning forward onto a bed for the final hours of a 7-hour labor, and pushed out the baby through the intense burning sensation of the perineum that others have described. During that labor, I felt completely overwhelmed. Yes you get a break between contractions, but the intensity of the pain and its visceral nature was mind-bending. I described it afterwards as feeling like I was being tossed about on a capsizing boat in a hurricane, clinging to the overturned hull, and struggling to hang on. Focusing on breathing through the contractions kept me from crying out, but months later when I saw pictures of myself in labor, I was brought to tears just remembering the experience. Nonetheless, I was pleased that I had managed to give birth under my own power, and that I had not panicked when my midwife was unexpectedly unavailable during the birth.

    My three subsequent labors were much less intense - even easy by comparison, and I have provided details in a previous comment on the "what does giving birth feel like" post.

    My most intense sensation during contractions was a stretching feeling across my lower abdomen, but describing it that way just doesn't do it justice. It was like the painful feeling of a rope burn magnified to the utmost and radiating outward from this band of tightness across my bikini region. For me, it was most intense in the front, but I could feel it both front and back, and encircling my body hip level. I remember during my first labor being stunned that people would describe this as "discomfort." If that's discomfort, then the word needs to be redefined. I found it extremely, exquisitely painful. It did become less intensely painful with each subsequent labor, but the distinctive sensation is unforgettable. I'm assuming it is due to the uterus pulling the cervix open.
    I think that most women experience their first birth as the most painful as, everything else being equal, it really does require more intensity to open the cervix and expand the birth canal the first time. However, the size of the baby, its position (anterior versus posterior, asynclitism), etc. can also have effects that could make a subsequent birth more intense.
    I have a large pelvis, which I'm sure made labor and birthing easier for me than for many women. I was fortunate never to experience back labor or a really long labor. After my first birth, pushing the subsequent babies out was not painful, and my midwife commented that she noticed that I was able to gently and gingerly birth the head and shoulders and avoid tearing or other trauma to the birth canal. The idea of being exhorted to hold your breath and "Push" during birth, not to mention all the other aspects of the medical merry-go-round, seems beyond aggravating to me.

    I found giving birth to be a profound experience, both physically and spiritually. I realized that I am capable of so much more than I had known before.

    I am very glad I was able to experience birth on its own terms.

    DJ Lane

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