“Undisturbed birth does not imply that birth will be pain-free. The stress hormones released in birth are equivalent to those of an endurance athlete, which reflects the magnitude of this event, and explains some of the sensations of birth. And like a marathon runner, a woman’s task in birth is not so much to avoid the pain – which usually makes it worse – but to realize that birth is a peak bodily performance, for which our bodies are superbly designed. Undisturbed birth gives us the space to follow our instincts and to find our own rhythm in an atmosphere of support and trust, which will also help to optimize our birth hormones, aiding us further in transmuting pain.” – Sarah Buckley, MD., Gentle Birth, Gentle Mothering. (link to Sarah’s blog here: http://sarahbuckley.com/category/blog)
You may have had a similar experience to the one I share: Being given Pitocin to make my labor progress more quickly, and then an epidural– as I could not take the pain of the stronger sensations from the medication, lying on my back, attached to continuous monitors and intravenous fluids, without any labor support or doula. I was in my early twenties back then. I didn’t ask many questions and assumed this was standard procedure when bringing life into this world. And I was an obstetric nurse on the unit where I was laboring! This was what I saw and thought was routine.
Also, statistically, these are very common practices. However, no one shared with me the opportunity to have a natural, undisturbed, well supported childbirth. There was no online information or many books about it available to me back then, and because I didn’t have anyone in my life talking to me about intuitive pregnancy and birth as a normal physiologic process, I thought I was covering all my bases when I was eating healthy, exercising, attending all my check-ups, tests, screenings, and taking Lamaze.
They say that when the student is ready, the teacher appears….
…and perhaps I was not yet ready to dive into myself…. And let go…. I was so young, and scared by what I saw in the hospital and heard from others.
This blog post focuses on the mindset around ‘pain’ during labor and childbirth, as well as my perspective on managing it in an out-of-hospital birth setting.
Photo by @alwaysmatilda_katie
What do you do at home if a mom can’t take the pain of labor and wants an epidural? How do you manage pain at home?
In all my years as a homebirth midwife I have not once had to transfer a mama to the hospital for epidural or pain meds because she could not cope with the sensations of normal labor. Not once.
It is not because women who have home births have different bodies and no intensive sensations. It is largely the mindset, the language we use, the attitude, the preparation in advance, and how the mamas are cared for and supported in labor.
I was always terribly frightened about pain after my experience giving birth to my first two babies on the obstetric unit where I worked as a nurse - one in the operating room while I was waiting alone for over an hour, waiting for the assistant surgeon to come perform an emergency cesarean because my baby’s heart rate dropped dangerously from the medications. My baby was miraculously fine (so much for the accuracy of the monitoring, as there was no emergency after all; so much for feeling safe in a hospital that took over an hour to rescue my baby from the emergency stress they allegedly caused), but I was not fine. That and my similarly handled second birth were the most traumatic experiences ever.
When I woke up and went to midwifery school and began to heal from my own birth traumas, I was still petrified of the pain and wanted to see if the wimp I considered myself to be could do it without an epidural. I wanted midwifery and natural birth to work for me to be authentic about providing that kind of care.
I told my fears to my midwife and she validated me. She also reassured me she was confident I could do it naturally as I was now with a midwife and my care will be very different - I would be eating and drinking, upright, moving and vocalizing freely, and would be more empowered, supported, and encouraged to trust my body’s ability to give birth; She was sure I would surprise myself.
She was so right. I felt so healed and like a superstar after my next two babies were born without epidural or any pain meds, just loving excellent midwifery care and encouragement to tap into my own capacities and strength as a woman.
Being in the water helped. Movement and moaning helped. But a complete shift in mindset and perspective was key, as was my preparation. I learned to use different language for the sensations of labor, instead of pain which implies illness and something that needs to be remedied, and to see them for what they were. I learned to use other words for contractions, which imply tension and negativity, and the word contraction is not empowering, and does not fully explain what is happening. Yes, the top of the uterus contracts so the birth canal can open and expand, as well as push out my baby. So expansions are also happening in labor – that is really the goal of what I am doing – expanding so my baby can emerge from my womb to the outside world, and we can both be birthed as a new mother and baby.
Suffering is a choice. And I chose to embrace my intense sensations for what they were, as healthy signs, what was needed to birth, what my baby needed to transition earth side - not that anything was wrong.
They came in waves with a delicious rest in between and I kept staying in the now. My yoga and mindfulness helped me calm myself, witness and get curious about the sensations, to release and dive right into them without fighting them, and notice that most of my body actually felt fine. I also noticed that when more relaxed, the labor was easier and the sensations were less intense, easier to deal with.
I could do anything for 60-90 seconds, every few minutes at the maximum. I also felt confident with the support I had - and the peak intensity was only at the peak of the wave in later stages of labor, when the waves are at their most intense, closest interval and longest duration. Prior to that, they are shorter, less frequent and not as strong – so even more manageable. Later labor I knew was a relatively short period of time, and as indication that my baby would be born soon. So, that's the kind of care I provide and encourage others to provide.
Natural hormones for management of labor sensations
“In labor, such high levels [of beta-endorphins] are released and help the laboring woman to transcend pain, as she enters the altered state of consciousness that characterizes an undisturbed birth. In the hours after birth, elevated beta-endorphin levels reward and reinforce mother-baby interactions, including physical contact and breastfeeding, as well as contributing to intensely pleasurable, even ecstatic, feelings for both.” – Sarah Buckley, MD.
These natural pain-killers are programmed perfectly to release and work with a woman’s body and her baby as she progresses through pregnancy, labor and after-birth.
Beta-endorphins work with another hormone produced naturally, oxytocin, the love hormone, to contract the uterus before and after the baby is born. Physiologically, a birth in which a woman feels safe, heard, supported, loved and undisturbed, a woman’s body is a divine machine that was designed with miraculous and purposeful intent.
Although epidurals and other interventions have their place and are beneficial when necessary, routine use of them interferes with the natural tendencies and process of labor, as well as birth and the after-birth period where breastfeeding and bonding between mother and baby are so important.
Can labor and birth actually be pleasurable?
Many women who I have cared for in my practice have used the word “ecstasy” to describe it! I have helped mamas dance, laugh, sing and sensually release their babies out.
Just as I have compared some of the experience of labor and birth to that of a marathon runner, feelings of ecstasy can be compared to something similar to a runner’s high. Although birthing your baby is a much more powerful, peak-like experience as you can imagine, this is an experience a woman may only have once or a few times in her life.
“I never thought I would see the day that anyone other than me would describe childbirth as total ecstasy! I know exactly what orgasmic birth is – I have experienced it myself. There is absolutely nothing else on earth like it. There is no moment in a woman’s life when she feels stronger, more capable, more an embodiment of the Divine than when she pushes her child into this world.” – an excerpt provided by Christine B., included in Elizabeth Davis and Debra Pascali-Bonaro’s book, Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience (link to Debra’s blog here: http://www.debrapascalibonaro.com/blog/).
Oxytocin is released both during love-making and during labor. There is a deep connection between the love that put baby there and the love that helps baby come out. It’s the same sensual energy that is needed, in an atmosphere and mindset conducive to it flowing organically…as in making love, as in giving birth.
A woman’s relationship with her body, both sexually and sensually, can be an integrate part of experiencing labor. The contractions and expansions that occur during labor and childbirth are comparable to those of orgasm.
Most of us have grown up with a belief about labor and childbirth, one in which it has to be painful. We hold a vision in our mind of a pregnant woman, screaming in pain, wearing a hospital gown, with her legs up in the air, an obstetrician and nurses taking over – doing all sorts of emergency care on the laboring mother. That is what we are told by many others who have given birth in many hospital settings for the last few generations.
Even if it’s just something we’ve seen in the movies, it would lead anyone to sign up for an epidural without question. No wonder there is a prevalent fear and lack of self confidence.
However, it is possible to embrace and lean into the sensations of labor, rather than fear them or try to escape them. It is possible to birth with joy, and even sensual pleasure.
When a woman prepares for this process, she can feel the momentum that labor provides. She can be guided by her own intuition and the trust of a supportive team around her. Mindset can shift to a positive perspective about the sensations of birth and it’s fully possible to have a birth that leaves a woman feeling empowered, strengthened and deeply satisfied. It is possible for her to feel a sense of bliss like no other, despite the intensity and challenges she may face.
Also, this outstanding documentary, Orgasmic Birth here is a must watch! And I was honored to be in it!
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