Want to know about pain in childbirth? Ask everyone you know who has had a baby… female relatives, friends and neighbours. You’ll discover a huge variation in comments: “almost no pain” to “the worst in my life”. Some women don’t even bother to find out about the pain and choose an elective Cesarean or pain relief.
Be brave and ask every man who has been at a birth what he thought about labour pain and what he did.
Is this a challenging thought? That tells us something. Childbirth is not talked about much except for Birth Story snippets. We have little exposure to birth except our own and each one of those is different. Where are you learning about childbirth pain?
Now ask everyone what skills they learned, practiced and now use to drive a car. Surprise! Every driver is expected to learn, practice AND use the exact same set of skills.
Isn’t giving birth bigger than learning to drive? Why don’t we have a common set of skills to give birth?
Individual Birth Cake Recipe
Childbirth is such a personal experience and we are each unique. Couple that with one Truth about birth: “there is no way to know what your birth will be like”.
Add our lack of exposure to a hundred individual births.
Mix with another Truth: pregnancy and childbirth are a natural part of a woman’s life.
Blend in some philosophical messages: “Cats aren’t taught to birth, women don’t need to be taught”, and “just trust birth, you’ll know what to do on the day”, and “get out of your thinking brain, into your primal brain and let your intuition and instincts lead you”.
Stir with another Truth: we can’t practice before hand.
Put on the frosting: pain is part of childbirth.
That’s the present recipe for childbirth. So what are you going to do if you feel intense pain?
Add some very confusing ingredients:
We’ve all heard that many women suffer in childbirth and others talk about achieving a birth orgasm. While some women experience a birth orgasm most of us do not connect the pleasure of an orgasm with the intense pain often associated with labour. Most women are just plain relieved their birth is over and glad they didn’t die as many thought they might when overwhelmed by the pain.
Of course, a further special ingredient is added to the mix:
Your Birth Plan — what you want or don’t want to happen at your birth. Your Birth Plan is all about what you expect from others.
However, one important ingredient has been left out:
What you will do, how you’ll behave, act, manage and cope during the birthing process and what your partner will do to really help you rather than just “be there”.
Our commonality
Our commonality is also missing. We can all blink, cough and tighten up our rectum — both women and men. Once a woman becomes pregnant she joins a group much like drivers. One hundred percent of pregnant women will give birth one way or another. This oneness means something: We can build on commonality to create skilled birthing women and skilled coaching men/friends or relatives.
Physiology is not the same as intuition or instinct
A hungry child experiences a normal physiological urge to eat. Do they intuitively or instinctively know what foods are safe to eat or poisonous? No. Humans are not hard-wired to know what foods are safe. We have to learn.
All humans are animals. Drop a person off into the woods would they trust their instincts and intuition to survive for weeks, months or years? No. Humans are not hard-wired to survive just because we are animals. We have to learn.
We experience many physiological processes but we don’t always know how to deal with those intuitively or instinctively. Giving birth is a physiological process. Knowing how-to birth is learned.
By the way, fathers and others sharing the same human body are expected to come with us, supposedly with a role to support us. They can take a more pro-active role: to know how-to help you
Human brain
Humans have a unique part of our brain … our neo-cortex, located behind our foreheads. The neo-cortex is where skills are learned, practiced and held. Humans love being skilled. Most humans do not feel comfortable winging it.
The ability you and your partner have to use skills during childbirth comes from learning and practicing them during pregnancy.
Self-learn
Learning childbirth skills and practicing must come from self-learning. Although you could watch others drive, you still had to get behind the wheel of the car and practice all the skills by yourself. It took weeks for you to coordinate all your driving skills before you could pass The Driving Test (sort of like The Birth). No one could learn for you. Once you moved past feeling stupid and uncoordinated you felt more confident. When you self-learn and practice skills then you own the skills. They become part of your mind/body relationship. Self-learning gives the confidence to choose how to use and adjust the skills at any moment … just like driving.
How do humans naturally react to pain?
Stub your toe or prick your finger — what do any of us do? We immediately tense up. We can remain tense until the pain lessens! All humans intuitively and instinctively tense up to intense pain.
Tensing up INSIDE our pelvis during the birthing process can hinder our baby’s journey down, through and out our body. We don’t intentionally do this. We instinctively tense up. With childbirth pain it’s ok to tense up on the outside. Your baby isn’t coming out your shoulders. But we must keep the inside of our pelvis softened and mobile. Our baby comes out there.
As humans we have 3 types of tension:
- Conscious tension such as when we experience pain. We can choose not to tense up, but this can be challenging.
Conscious tension skill:
The next time you experience pain, intentionally let go of any tension you feel. This is great practice for labour pain. You are training your mind to control your body’s reactions.
- Unconscious tension. Humans walk on two feet. Our muscles and soft tissue hold us up and physiologically hold tension. We don’t ooze across the floor.
Unconscious tension skill:
Notice when you walk, the tension in your bottom and lower belly. Let go of that tension. This is great practice for labour. If you walk you’ll use your brain to let go of “weight bearing”, unconscious tension.
- Structural tension. Some women have tight internal muscles and quite rigid soft tissue inside their pelvis and birth canal. Your baby is a big object that stretches this tissue and causes pain.
Structural tension skill:
Both of you can notice the bones you sit on. If there is tension between those bones, it’s harder for your baby to come down, through and out. Keep the space between these bones open and don’t tighten up “down there”. When we feel pain it’s common to tense up “down there”. We have to be counter-intuitive and let go while feeling pain. By doing so we choose to work with our baby rather than react to what we are feeling.
Women don’t control labour
If we could control labour then we’d choose how long and how intense each contraction was. We can’t do that. This means we often feel out of control. Our baby stimulates our body to be born. The contractions are the messages our baby gives us. We have to learn to read those messages. This in itself is a skill.
When we properly prepare our pregnant body to become a birthing body; learn, practice and use very specific skills during the birthing process; we can help this physiological separation. You can always work with your baby’s efforts to come down, through and out of your body/container if you have taught yourself the skills. The operative word: self-learn. The key to success: practice. The goal: birth better.
Remember you taught yourself how to drive and you still use those complex skills at every nano-second while behind the wheel.
While you can’t control what is happening to your body, you can control how you respond. Being skilled is about using our amazing mind and body together.
Pelvic Clock Skill:
Both of you can do this. Right now soften inside your right hip, then soften inside your sacrum (the big bone at the end of your spine) and lower back, then inside your left hip and inside your pubic bone and lower belly. Doing so helps your cervix to dilate. Your partner can remind you.
Labour pain is different than other pain
Pain is often connected to injury, disease and death. Ask your midwife or specialist if any medical problem causes increased pain in labour or whether the increase in pain experienced in labour indicates a medical problem. There is one rare occurrence: the separation of the placenta before birth, which is a medical emergency.
If you have a breech baby, go into labour prematurely, or after your due date, there is no increase in labour pain. If you have heart problems, asthma, diabetes or high blood pressure there is no increase in labour pain. Pain in labour is normal, natural, productive and hurts.
Back labour is not a medical condition.
Neither back labour nor a posterior birth is a medical problem. Some babies lay that way. Ninety-nine percent will spontaneously turn sometime during pregnancy, early labour or during the birth. An anterior baby can cause back labour. This pain is caused by pressure on the sacral bone.
The present “skill” to relieve back pain is pressure on the sacrum. This might help reduce pain for the woman but it closes off space your baby needs and may delay the birthing process. Keep your sacrum mobile, stay open between your sit bones and continue to soften inside your Pelvic Clock, giving more space for your baby.
The pain of labour is natural.
Labour pain is often unpleasant and causes the “suffering” women talk about. Without skills to cope, manage, and deal with this naturally occurring pain women feel out of control. For millennia women have been told “there is no way to know what your birth will be like (true) therefore there is no way to prepare for birth”(inaccurate). Birth unfolds. Have and use your skills.
The cause of labour pain
Intellectually you’ve been told, read or researched that birth pain is due to dilation of your cervix. Knowledge is information. Skills are what you do with that information.
Contractions are a powerful muscular action that simultaneously open your body internally, and move your baby downwards.
During 1st Stage of labour, you can feel pain from:
- the contracting muscle itself pulling the cervix open
- the baby stretching open the soft tissue inside.
- pressure on the inside of your pelvic bones as your baby moves down (back labour, baby “hung up” or stuck, hip or pubic bone pain).
- Early labour is usually manageable – the sensations aren’t strong. Your cervix is just beginning to soften and open … usually up to 3cm.
Learning Skill:
This is the time to learn the rhythm of your baby’s efforts even if you don’t feel too much pain.
- Pain increases as your cervix is tugged open … between 3-7cm. Now’s the time to teach yourself how to manage, cope and handle the increased pain by focusing on your skills.
Management Skill:
Your mind may begin to tell you things like “this is too hard”. Just respect that voice and choose to use your skills to manage the sensations. No one says this will be easy. Having a skilled partner is essential.
- From 7 to 10 cm the pain reaches its peak.
Default behavior Skill:
Your skills need to be your default behavior. Change and modify them at every nano-second like when you drive. You are driving your birthing body as its passenger works to get out. You can hate every second and still manage your birth brilliantly.
One woman nailed it: ‘I made a choice with every inhalation to open and expand inside my pelvis and to use each exhalation to soften inside my pelvic clock’.
Did she feel pain? You bet. Her negative voice did a lot of swearing but her managing voice chose which skills to use. She felt incredibly proud of herself
Her partner reminded her or modelled this type of breathing skill. We have the SAME body.
With a common set of skills your loved one can help you “stay on top” of the contractions. Women want to be able to manage and cope with labour pain and not feel overwhelmed.
Most women use medical pain relief because they lack skills to cope with the natural occurring pain NOT because there is a medical problem. If you choose to use pain relief keep using your skills. Skills are what you do during this activity even if it’s challenging. Do you think being a parent won’t be challenging? Skills always help us even in challenging situations.
During the 2nd Stage of labour, pain is experienced as a specific stinging and burning as your baby pushes through the vaginal opening (the unfamiliar stretching of these muscles and soft tissue). The intense pain of dilation is over.
Progressive labour
Your skills can help you have a progressive labour. As one woman said: “I didn’t waste one contraction”. In progressive labours, each contraction reaches a peak. Your baby is telling you he/she can open your cervix and move down, through and out your body. When labour “goes off” contractions don’t reach a peak, but level off at a plateau. Women aren’t taught to listen to these messages.
Progressive labour skill:
Stay out of positions that cause your contractions to go off. Get into positions that bring on effective contractions. Reduce tension in side your Pelvic Clock. No one says you have to like labour pain. You have to manage it.
Lacking skills, women often get into positions that ease off intense, effective contractions. This may well delay the birthing process. You want effective, progressive labour contractions. With skills you’ll know you are working with your baby’s efforts to be born because you are reading his/her messages. This is empowering. Your skilled partner can hear the difference and help you.
5 phases
Even with the above skills labour pain can still cause you to tense up. It HURTS! But here’s another skill. Each contraction has 5 Phases so there are always opportunities to relax.
- As a contraction starts put some skill into play.
- Work with a skill as the contraction moves toward its peak.
- With help from your birth partner use determination to use skills during the peak.
- As the contraction eases use your skills to let go of any internal tension. This phase ends after you’ve taken 2-3 deep cleansing breaths (another skill your birthing partner can do with you).
- When the pain goes away use your skills to soften inside your Pelvic Clock.
You can always feel in control of your own behaviour.
Unfortunately most women just feel birth happens because they are locked into a cycle that says you can’t prepare for birth because it’s unknown … but it’s not unknowable when you know how!
The author went to a tribal village in Pakistan. Generations of people have lived together for hundreds of years. When asked how their mothers taught them to breathe in labour, few mothers had taught their daughters anything, and those that had gave varied opinions: breathe shallow and fast; hold your breath; don’t make sounds; make lots of noise; breathe deep and slow; or, it doesn’t matter. Yet when asked how their mothers taught them to make bread they ALL had the exact same skills.
We have a multi-generational problem that can begin to change in your generation. We are fortunate in New Zealand to have a Midwifery Model of care that advocates a Partnership. Being skilled is our partnership responsibility … both mothers-to-be and fathers-to-be/friends or relatives.
Birth Plan skill:
Make Two Birth Plans. The conventional one is about what you want or don’t want. The new one tells your midwife and specialist how you are preparing your pregnant body and what skills they will see you and your birth partner use.
Women and men alike can learn skills to work with a baby’s efforts to be born.
Emergency or Elective Caesarean Skills:
If you then have an emergency c-section just continue to use your skills during surgery to stay connected. Having a non-labouring Cesarean? Enjoy preparing your body to give birth, and use your skills on the way to hospital, while being prepped, and during surgery. Birth is always your baby’s birth day so you stay totally engaged. Birth is always an activity you will do with your baby. It is never a dental appointment.