Pain in labour and birth
Let’s talk pain in labour and birth.
Culturally, so many of our conversations around labour and childbirth focus around the pain, and what pain relief options you did or did not avail yourself of.
But to begin to understand pain in labour, in order to work “with it” — we need to distinguish between physiological vs pathological pain, induced labours vs spontaneous labours, and the role of environmental factors including birth space, support team, and your previous life experiences with pain and intense physical events.
Pain in labour is generally physiological pain — pain with a purpose, associated with the physiological processes of normal labour. To be contrasted with pathological pain (pain because something is wrong, associated with injury or disease).
Physiological pain experienced in a labour that commenced and continued spontaneously and without intervention is, by in large, pain that builds gradually, with breaks between contractions to allow you and your baby to take a breath. Like the pain of running a marathon, or similar physical endeavours. Pain that shows your body is at peak performance, working under the influence of “queen oxytocin”. Pain that your body meets by pumping out its own hormonal pain-relief in the form of beta endorphins.
This kind of pathological pain is to be contrasted with pathological pain — when something is wrong. Or the kind of intensity you may experience when your labour is induced with synthetic oxytocin (syntocinon), where the pain frequently comes in thick and fast, without your body (and essential hormones) being prepared or able to meet the escalating intensity, and often without the kinds of breaks that you (and most notably your baby), need.
One of the first comments you are met with when you say you are having a homebirth is “does that mean no pain relief!?” and a look of terror on the face of many. The answer is no — generally, at homebirths there is no pharmacological pain relief (athough some models of care can facilitate nitrous oxide, “gas”). And for the most part — you do not need it. The supportive home environment, knowledge and understanding of the function of labour pain and the process, freedom to move about the spaces that bring you joy in everyday life, and the emotional and physical support of incredible care providers, along with a healthy dose of water immersion or a TENS machine, is what carries you through. The fact that labour unfolding in this way provides moments of complete relaxation between contractions, is not to be underestimated.
There is no denying the intensity, and the relief when it’s over. But also the elation and knowing you have done it. Let’s celebrate it like we celebrate other moments of immense physical achievement, while also acknowledging the impracticability and unfairness of holding women to this “drug free” ideal when their labour and birth doesn’t isn’t accompanied by these same kind of protective environments and mechanisms.
More details on the choices around pain relief, and the evidence around them, coming soon.
