Pain AND Pleasure?


Have you listened to the podcast The Longest Shortest Time? Episode #28, The Missing Chapter to Ina May’s Guide is so worth the listen. Please pop over there and do yourself a favor – then come back to me here. The interviewer, Hilary Frank speaks to Ina May Gaskin – yes, the Ina May Gaskin, the grandmother of the natural birth movement. And she basically tells Ina May how she felt betrayed by both her and the NBM when her birth ended up not being at all what she expected after reading all the “right” books and doing all the “right” preparation for what she hoped would be an “ecstatic experience.”

I think it’s totally okay to say to pregnant folks, “You’re probably going to experience some pain with your birth.”

Now what level of pain a woman experiences during her birth depends on tons of different things: Is she tired and hungry going into labor? Has she taken a class that’s really emphasized how to cope with contractions? Are there a lot of tried and true tools coming into the labor and delivery unit with her? Is she feeling confident or fearful of the birth process? What’s her labor support team look like? What’s her personal pain threshold? Is her birth slow and steady, or fast and furious?

There’s lots of extenuating factors that will have an impact on her ability to cope with contractions and manage them effectively without any pain medication. There are some women who really feel that the pain of labor and delivery is negligible! One of my students actually said, “I’ve had paper cuts that were more painful than my birth!” In my experience, she is the exception to the rule.

But having a painful birth doesn’t mean it has to be a negative experience.

When I hear that a birthing person felt like their birth was not painful, I’m thrilled! And so is the person who’s telling me their birth story! But they’re usually happily surprised by this turn of events.

In my classes, my families are prepared to work hard through contractions and know they will most likely experience some level of pain and discomfort as they’re going through labor.

I don’t ever want anyone to be angry and disappointed that they experienced pain with their contractions. I want them to have realistic expectations that birth, for most people, is painful. I don’t emphasize that point, and I don’t dwell on it, but I think they should be prepared.

If they have the expectation that there will probably be pain in their labor – no matter how well they practiced breathing with their partner in class, no matter how often they change positions, no matter how they’re using the “doula’s epidural” of getting in and out of the tub for pain relief – then a laboring person can work with their pain and not be overcome by it.

Rather than making pain the star of the show, can give it a minor supporting role and move on. Maybe this will allow you to actually enjoy the experience of giving birth.

It might seem like I’m talking out of both sides of my mouth:

“Birth is going to be painful.”

“Birth is something you can enjoy.”

But I think both statements can be true. I try and have my families imagine something that they’ve done, a physical challenge of some sort, that was painful to get through, but still left them feeling positive, happy, satisfied, proud of themselves, and accomplished once it was over.

Then I’ll ask, “At any point, did you feel like you were suffering?” If they feel it was a positive experience, the answer will almost always be “No.” If I press and ask if it was painful,  they might respond with – “It was one of the most painful things I’ve ever gone through – but it was so worth it!”

They would not be able to respond this way had they experienced suffering.

It’s so important to make that distinction between pain and suffering. They’re two very different things. Pain is something we feel, suffering is our overwhelming and negative perception of that pain.

No person should ever suffer through birth. If they ever reach that line that separates pain from suffering, then we’d better be doing everything we can to keep them on the side of continued coping. If they’ve crossed that line and moved into suffering, then we need to do something immediately or they can be traumatized by this experience – even if it goes according to their “natural birth” plan.

What about the person who hopes for an unmedicated birth, but goes into the experience thinking, “If the pain gets to be too much, if I think an epidural has become medically necessary, I’ll ask for some relief.” They may not end up needing this relief. But identifying a tool to help them if they begin to suffer is what counts here. An epidural as a medically necessary choice allows them to care for themselves during birth without feeling like they somehow failed, like they weren’t strong enough to get through without drugs.

More than anything, I want people to enjoy their births so that they’re able to move into parenting from a place of peace and confidence, feeling proud and accomplished by what they’ve just done.

I might sound like a broken record, but a birthing person – despite mode of delivery – has co-created a new human being, grown their baby in the perfect environment and then on the day of birth, they either open and push their baby through their body into this world, or they go through major abdominal surgery to bring their baby into this world. They have already done an amazing job. They have already done more than enough.

Feeling guilty about needing to use interventions like medication or surgical delivery to birth their baby has no place in the postpartum experience.

When a person is feeling betrayed by their body, by the medical establishment, by the natural birth movement, they cannot fully enjoy their experience of pregnancy, birth or new parenting.

There’s not enough room for enjoyment – there’s only room for anger, blame, and shame. How does this benefit them in their new identity as a parent? How does this benefit the couples relationship?

I think it’s entirely possible for a person to enjoy birth, no matter what the circumstances, but we need to provide the birthing person with realistic expectations about labor and delivery first. We need to encourage them to find their voice and participate fully in the experience. They need to surround themselves with the right people as members of their support team. And then they need to be prepared to make the hard choices that weren’t a part of the original plan if they become necessary. In this way, they might experience pain, but they can also enjoy the pleasure of giving birth.

When you gave birth were their moments of pain? How were you able to tolerate the pain? Did you enjoy giving birth? What made that possible for you?


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