I admit, I feel a little fruity sometimes when I talk to my birth class mamas about their relationship with labor pain. Like, no, I would like to permanently break up with pain and throw its old t-shirts out of my second-story window. Maybe even key its car. And during labor, that goes at least double, like some kind of bad country song. A relationship with pain is something that moms-to-be want distinctly to be out of. And yet, that baby has gotta come somehow, and so it’s inevitable that contractions, and the accompanying discomfort, are going to show up at some point. So what is a laboring mom’s relationship with her pain? It could go one of two ways, broadly speaking. The first involves a lot of, “No no no, go away, this is really bad and I want it to stop,” whereas the second way is more accepting and surrendering: “Ok, here it is, I can do this.” There’s a significant difference in the amount of pain perceived depending on which of these two ways you respond.
The Panic Cycle: Avoid Labor
The thing is, your thoughts about pain have a pretty direct relationship with what your body does, which in turn influence the amount of pain you are likely to wind up experiencing. Want to minimize your perception of pain during labor? When a contraction starts, you can either start down a peaceful cycle or a panic cycle. The chain of events in the Panic Cycle lead to tension and more pain, which in turn can make you even more fearful of the next contraction. Check out some examples of the thoughts, feelings, and behaviors that might loop you into the Panic Cycle during a contraction:
Contractions are too hard for me to deal with.
I can’t keep doing this.
I’m not strong enough for labor. It’s too much.
I need to escape the pain of contractions.
This pain is not ok. I am in danger. This is terrifying.
I’m at the mercy of my contractions.
Avoidance of labor
Fear of the next contraction, and of the duration of labor
Unwilling to shift attention to comfort measures and emotional support
Believe comfort measures won’t help
Overwhelmed, desire to escape
Tense body in response to contraction
Clench muscles, especially in face and buttocks
High, frightened sounds ; crying out
Focus on pain instead of redirecting to comfort measures
Try to escape labor; increased perception of pain
That kind of seems like a rough place to be, does it not? It’s counter-intuitive; usually, pain lets us know something is wrong. In those cases, a fear/escape response might be appropriate. But in labor, pain isn’t signaling harm. Rather, it tells us something big is happening! Labor pain motivates us to get to a safe place with safe people, in preparation for birthing a baby. Labor pain causes us to get into different positions to bring relief, which also encourage baby to make its way down through the pelvis. So if labor pain isn’t the enemy, then consider a more peaceful way to say yes to contractions:
The Peaceful Cycle: Surrender to Labor
My pain has a purpose: opening my body, birthing my baby.
The pain will come and go. I will get a break.
I can track with one contraction at a time.
This pain isn’t harming me, even though it’s intense.
I am able o cope with pain in order to have my baby.
I am in charge of how I cope with this contraction.
Acceptance of labor and its duration
Respect for my body (pain = power!)
Patience with the process (most of the time!)
Willing to accept support
Determined and empowered to cope instinctually
Mental strength and focus
Sink into the bed, let body go heavy, swaying, moving
Loose, open muscles in face and buttocks
Low moaning sounds to help release pain
Tune in to support people, outside smells/sights/feels
Find a rhythm and ritual for each contraction
Surrender to labor; decreased perception of pain
I don’t know about you, but as hard as labor is, I’d rather let it happen and get through it one contraction at a time, than hop the crazy train toward even more pain. Kind of like how you can either fight with your crazy roommate all of the time, or just accept that she’s there, deal with it, and look forward to the end of your lease. Except the roommate is your powerfully contracting uterus, you know? What a great metaphor. Your crazy wombie. It works on so many levels.
Relaxed face = I’m ok, I can do this; my amazing wombie is just doing her job.
Pinched face = I’m not as ok, I need more support. I hate my wombie right now.
So, your thoughts about what is happening are just as important as the facts of what is happening? Uh, yup. The fact is that you’re in labor, and your discomfort is the proof that amazing, powerful things are happening inside your body without you having to orchestrate it. What you do with that information will directly influence your experience of labor. There are several ways to build a peaceful mindset toward labor to help minimize fear and pain.
- A good natural childbirth class will help you know what to expect in labor (physically and mentally), and can help you maintain the peaceful cycle of thoughts, attitudes, and behaviors through relaxation tools and comfort measures. I believe that not knowing a lot about natural childbirth puts you into the position of fearing the unknown, as we all do, especially when it is happening to your body in a very real way. Thus begins the fear —> tension —> pain cycle.
- Reading lots of positive birth stories ahead of time can also help develop an accepting mindset toward labor. Ina May Gaskin’s “Guide to Childbirth” is packed with such tales from women who embrace labor as natural, purposeful, even beautiful. They don’t gloss over the immense challenge of childbirth, but neither do they fear it.
- Invite people onto your birth team who will contribute to a positive, calming attitude toward labor. Even a beloved, trusted family member might not be a great labor support if they see labor as something to be feared, avoided, or escaped. Or if you think they might freak out seeing you in pain, doing the intense work of labor. Surround yourself with one or two people who know you well, are confident in natural birth, and will speak the calming truth to you when your brain temporarily goes on hiatus to panic city.
- Develop peaceful mantras to help you during labor. I attended a birth with a mama who printed, decorated, and then strung positive labor mantras around her delivery room in the hospital. Everywhere she looked, she would spot a peaceful phrase to help her focus on surrendering to each contraction. Each of us on her birth team could repeat the same phrases to her when she seemed overwhelmed or tired. “I breathe, I relax, I open”; “My body was made to open for my baby”; “I am not afraid to birth my baby” are all great options, or you can reflect on your own positive reminders for labor.
The good news? Labor is such a dynamic process that even if you start out on the crazy train (Panic Cycle), you can learn as you go, lean into your instincts to move and vocalize, and in between contractions, make a plan to ride the Peaceful Cycle on the next contraction. In fact, lots of women find themselves alternating between peaceful and panicky thoughts at different points in labor. There’s always a choice to do and think differently on the next contraction. And the more you get into the Peaceful Cycle, I think the easier it is to surrender and stay there as labor intensifies (or to get back there, if you temporarily lose focus). Find your rhythm, shape your ritual. And once that sweet baby has finally emerged from your body, one way or another? Then you can send up a hearty hallelujah and know you’ve kicked your labor pain to the curb for good. Congratulations, mama!
“She believed she could, so she did.”
This blog is written by Elizabeth Pearce, PsyD, CD(DONA) Women’s Wellness of New Jersey’s Childbirth Educator