Does It Hurt? And Why Fear Creates Pain in Childbirth

Does It Hurt? And Why Fear Creates Pain “I would say the most surprising thing that I learned throughout my labour, was my newfound ability to manage pain, having previously been known to be a bit of a drama queen with the slightest bump, trip or stubbed toe. I had this feeling of power and strength and focus, to let my body go with it, and to breathe, just breathe.........breathe" Andreanna O’Neill Honestly, Does It Hurt? Everyone experiences birth differently, but I can put my hand on my heart and sincerely say that I cannot describe my birth as painful. It was hard work, lots of hard work; I think the comparison to running a marathon is a very good one. Hard work and rewarding. This is not the prettiest description of what childbirth feels like, but for me this is the most accurate description. It’s like having a big poo. Have you ever been constipated and been about to pass a big poo and thought: “Actually this is going to nip. I’m not sure if I can do this. Oh no, this poo is going to be sore!” And just when you think it’s so unbearable that you cannot possibly pass the poo, then the poo comes and it’s all over. And you think to yourself, “That wasn’t so bad after all.” Childbirth, for me, was like that. It’s the perception of pain and the anticipation of pain that makes something painful. Just as we talked about earlier, the fear (of the big poo/of giving birth), creates tension in the body (holding in the poo/holding in baby) that makes it painful (painful poo passing/painful childbirth.) Everyone has different experiences and perceptions of pain during childbirth. This is nothing to do with your ‘pain threshold’ or how ‘strong’ a person you are. No-one can judge anyone else’s experience of birth. Only you are in your birth and only you know how you feel. So if you honestly feel the best way for you to cope with the sensations of childbirth is to take drugs, then take drugs. But please, please keep an open mind at the onset and give natural birth a try. You may find it works out pretty well for you  The Fear Tension Pain Cycle "It didn't hurt. It wasn't meant to, was it, doctor?" When Dr. Grandly Dick-Read attended the birth of a poor English girl in the 1900’s, this is what she said to him when he offered her chloroform for pain relief. When he asked her why she did not want the drugs, this was her reply. Dr. Grandly Dick-Read was taken aback when he went on to witness the woman give birth without discomfort or pain medication. This birth set him on the path to looking at childbirth in a whole new way, as a normal physiological process instead of the terrifying painful experience it had been come to be seen as. When his book, "Childbirth without Fear" was published in the1930’s, the book was first disregarded as nonsense, but is now seen as a vital turning point in attitudes towards natural birth and childbirth as a normal, natural process and not an illness. This is a really fantastic book about childbirth which I would highly recommend. Dr Dick-Read continued to study birthing women and attempted to find out what made one birth experience so different from another. He came to the conclusion that the more a woman feared childbirth, the tenser she would become and as a result of this, she would have a more painful childbirth. When we become scared, our bodies go into ‘fight or flight’ mode. This means that the body releases a hormone called adrenaline which helps us to act fast and move away from dangerous situations. It diverts all of the blood and oxygen in the body away from ‘non-vital’ areas such as the uterus, to ‘vital areas’ such as the brain, arms and legs to give you more strength and speed to escape danger. The adrenaline which is produced can slow down or stop labour all together. This fight or flight mode has obvious benefits in the wild. So if you think about a labouring zebra (random) giving birth in the wild and a lion approaches, the zebra will go into ‘fight or flight’ mode and their body will literally halt birthing, often pulling the baby zebra back up into the womb, allowing the zebra to become mobile and get away from the attacking lion. Your chances of being attacked by a lion during childbirth are (hopefully!) very small. However, our bodies still work in exactly the same way. If we are scared of birth, our body will produce adrenaline. During birth our body naturally tries to expel baby, but the adrenaline produced slows down and stalls birthing. Therefore we have two systems fighting each other. We cannot ‘relax and let go’ and be stressed at the same time. Fact. What Physically Happens When I’m Scared of Giving Birth? Okay, now for the science bit. The uterus is made from two layers (well three but we only need to know about two) of muscles that go in two different directions. One layer runs from the top to the bottom and the other goes around the sides. During labour, the "first" set of muscles contract to push the baby down and pull the cervix back. After your baby is born, the other set of muscles contract to pull the cervix and uterus back into place. If you become scared of giving birth, the muscles around the sides of your uterus contract and tighten. This means that your uterus is working against itself - one set of muscles is trying to open the cervix while the other set of muscles is trying to close the cervix. This can make for a very long, painful, and unproductive labour. I’m sure you’ve heard of ‘failure to dilate.’ That’s exactly what this is.This came to be known as the "Fear-Tension-Pain" cycle because it works in a cycle: fear of birthing, makes the body tense which makes birthing painful. Our next blog post looks at relaxation as the key to easing discomfort during birth. This blog is adapted from the revised edition of Birth ROCKS by Cheryl MacDonald, available on Amazon in paperback and Kindle.

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