The subjectivity of pain

I had to just bite my tongue recently. Having a conversation with one of the docs, and he just goes on and on and on about how all women should get epidurals ~ so it "relaxes" their pelvic floors. Women "tense up from the pain" and it "makes the baby not come down."

Seriously?

Ok, he did mention that he had a kidney stone before, so he knew what pain was like.

Seriously? You're related a kidney stone to childbirth?

I quietly told him that childbirth pain is different. Women don't always need "rescued" from the pain. Some women do very well with the pain, and can find their "happy place" to cope with contractions. And lo and behold, they are able to relax their pelvic floor muscles enough to give birth successfully.

I also told him something that may have floored him: that I personally did not find labor all that painful. No, I'm not some masochist. Yes, I do experience severe pain. But pain from contractions? I personally found it very tolerable. BUT - I am also able to put myself into a light hypnotic state. I do this with childbirth and dental work.

Now, before anyone jumps at me on this topic: pain is very subjective. In other words, what I feel is mild/moderate/tolerable pain, someone else may feel it as severe. My coping ability of pain may be different than the next person.

Pain that I do NOT cope well with: surgical pain. It's a deeper, much more visceral pain that is continuous. Give me drugs. Lots of them.

Childbirth pain, to me, is an intermittent annoyance. Yeah, it hurts, to a degree. But I can cope well with it, and get into my "happy place" state of mind. Contraction pain has a definite beginning, peak, and end point.

My gut-wrenching IBS pain that comes out of nowhere? Kill me now please. I have prayed for death from that pain.

So back to contractions, pain, and coping. It's all about you, the individual woman. It's about what your response is to pain and how you are able to cope (or not able to cope). Do you go into childbirth with a positive attitude, well prepared for the rigors ahead? Do you have continuous support during your labor, telling you that you are doing beautifully?

I admit, at one point in labor with my 3rd child, I thought to myself "some drugs would be nice right now", but knowing that I was about 8 or 9 cm, it was too late in labor for medication. So, I just accepted it for what it was - labor. Deal with it, I said to myself. And I did.

Kindly share your thoughts on labor and pain/coping. Share your own personal births if you wish.

Various links today

Sometimes it's just a day for links!

Cultural Beliefs, Honoring the Placenta

The Placenta in Lore and Legend

Vernix - an analysis of it's microbial properties

A blog post about Vernix

Caput - what is it?

Umbilical Cord Abnormalities (March of Dimes)

Options for pain-free birthing

Tokophobia

Primary Elective C-Section

Amy Romano, I *heart* you!

Here is a post on Amy Romano's blog, Science and Sensibility: Are Consumers at the bottom of the evidence pyramid?

To sum it up: research is being done to find evidence of care in what we (medical/nursing people) do to the consumer, and not what involves consumer (patient/family) participation. Studies are done on perfecting surgical techniques, medications given, things of that nature, but studies are rarely done about what women/families do to help themselves or each other during labor, birth, postpartum and neonatal care.

I feel incredibly frustrated, as the health care provider towards the very end of a woman's pregnancy. I cannot, as the labor and delivery nurse, do a whole lot to educate women about their choices and how to empower themselves during their pregnancy. Women come to me on the L&D unit when they are in labor, have complications, or are being induced for labor. Yes, I do a whole lot of teaching about the labor process, pain management, coping/alternatives to pain medication or epidurals, the induction process, medical conditions, medical treatment and interventions. But it's almost like shutting the barn door after the animals have escaped. I am at the tail end of a woman's pregnancy. She has had nine months for education and empowerment -- but has she received it? Is it adequate enough for her to make informed decisions about her body and her newborn baby?

I am very excited though, as a midwifery student, about the possibility of being able to enact change. I'm excited about how I can help reach women in new ways to help them with their self-care, education, and their spiritual and physical pathways to becoming mothers.

(Side note: if you are interested in midwifery and the medical profession -- where it has been, where it is now, where it is going -- go read Midwifery and Childbirth in America by Judith Pence-Rooks.)

Mass Media Childbirth vs The Real Thing