Managing Pain in Labor

One of the best things about having a photographer take pictures at Zara’s birth is that through the photographs, I’m able to see parts of the birth that I was oblivious to at the time.  I’m able to see things that went on in other rooms and, what was most interesting to me, is seeing the photographs of myself laboring and delivering Zara.  I mentioned that one of the things Nora most talks about is how Zara tried to nurse on Chris; the other thing that she has been talking a lot about is how my face scrunched up when I was pushing Zara out.  Thanks to our photographer, I was able to get a third person view of how I labored. And, boy, did I make some funny faces (that last one is from when her head was coming out) — no wonder Nora keeps talking about them!

After looking at the pictures, I thought it might be interesting to write a little about how I manage pain in labor.  In all of my birth story readings, birth video watching, and talks with other moms, one of the things that most struck me is what an individual experience childbirth is, how differently everyone responds to the experience and how different coping techniques work for different women.  No one person’s experience is the same and, just as we tell mothers in LLL to do what works for their family when parenting, I believe that women also have to do what works for them during labor.  Pain medication certainly has a place in childbirth and can be a very useful tool for some mothers, especially those who have had previously traumatic experiences.  Because of how individual is the experience of giving birth, I would never think less of a woman for choosing to use medication.  But, I also believe that every woman has the innate ability to cope with the pain of labor without the use of drugs if she so chooses and if she is in an environment which is supportive of that choice.   And I strongly believe that finding the inner strength to manage pain in labor can be an incredibly empowering and strengthening experience for women.

One of the ways we can enable women to take control of their births and the sensations that come with the experience, is to change our cultural view of birth — which starts with the sharing of positive birth stories rather than fearful or overly negative ones.  Zara’s birth was my second natural childbirth and, though Nora was born in a hospital birth center, this is also the second time that I labored completely at home.  With both girls, I was lucky to have had relatively short labors, about 12 hours with Nora and just 5 with Zara.  I was also lucky to have babies that were positioned well and who did not cause me to have back labor or other particularly painful sensations.  Though Nora needed to be encouraged along, I was lucky to be able to get labor started at home with a natural remedy rather than through a medical induction at the hospital.  These things, the length of our labors, the position of our babies, and if intervention is (really, truly) medically necessary, are not things we can directly control and are only a few examples of aspects of birth that we just have to roll with.  Acknowledging this, I’ll agree that to some degree, there are women who are just luckier than others,but I also believe there are a lot of things we can do to set ourselves in the right direction.

I am a firm believer in the power of positive thinking.  When I was newly pregnant with Nora, I decided that I was going to have a natural birth.  I did not tell myself or others that I was going to “try” to have a natural birth; I just said that I was going to do it.  “Trying,” which leaves room for doubt, was never part of the equation.  From the very beginning, I made a point of thinking positively and confidently about labor and delivery.  I surrounded myself with positive people, from my friends, to my doula and midwife, all of whom supported and encouraged my plan to birth without medication.  While I left room for flexibility should a situation beyond my control arise, I did not leave room for negativity or doubt.  I took tales of bad birth experiences with a grain of salt and discouraged discussion of how awful or impossible to withstand birth is.  I didn’t fret over possibly bad or scary situations, instead thinking that everything would turn out well, because worrying about something bad happening before it even happens won’t help anything.  During both pregnancies, I practiced yoga and meditation and every day I focused for at least a couple minutes on visualizing my ideal birth.

Just as each birth is different, there are many, many different approaches to pain management during labor, whether through breathing, music, movement, visualization, vocalization, “coaching” from a birth partner, hypnosis, meditation, massage, etc.  I wrote about our doula following Nora’s birth, but it is worth saying again: if you can have a doula support you in labor, it is one of the best gifts you could give yourself and your partner.  That said, whether you have a professional support person or not, no singular approach will work for all women and, in many cases, until we have experienced birth, we don’t always know what will work for us.  Because of this, I think it’s good to plan to have a variety of coping techniques/tools available and it’s also hugely important to have a support person available who is familiar with a variety of methods for coping with pain.

During early labor, I love having people around to talk to, and at that point, I try to stay on my feet, moving through contractions.  Through the longer first stage of my labor with Nora, I walked around our neighborhood with Chris and our doula, often leaning on Chris if a contraction was especially intense.  Early on, I find activity and distraction especially helpful.  I believe that laying down or sitting in a hospital bed while in early labor is one of the worst things a woman can do.  For the most part, during the final stages of labor, I just want to be left alone.  The pictures from Zara’s birth say a lot about how I manage contractions and pain.  In nearly every picture until her head was just about to come out, my eyes are closed.  I am best able to get through each contraction by blocking everything out and focusing on my breathing.  I am not the kind of person who wants someone talking while contractions are happening; telling me I’m doing a good job or that it’s almost over just distracts me and takes my focus away from getting through the contraction.  I am a quiet laborer, not making much sound until I start pushing; I don’t need music to listen to or pictures to look at.  I like having positive support persons present, but once things get serious I like them to be more of an observer than actively doing things for me.

I think my tendency to look internally during labor is greatly influenced from my yoga and meditation practice.  I am by no means a yogini; many of the classes I have taken since getting back into yoga have been incredibly challenging and butt-kicking.  Maintaining particular poses, even in my imperfect expression, is often a huge challenge that requires focused breathing and an inner monologue encouraging me to stick with it.  I employ the same technique to get through a contraction: controlled breathing, positive thoughts, and a focus on just surviving the current contraction.  Instead of approaching labor as a long drawn-out experience of pain, I take each contraction individually; it is much easier to talk one’s self through 45 seconds or a minute of pain than hours.  Just as I know in a yoga class that we will eventually move into an “easier” or more restorative posture, I know during labor that I will always get a break in between contractions.  More than anything, for me childbirth is just a mental challenge.

It’s hard to explain how I get through labor without feeling like I want to give up on my goal.  Perhaps it is shear stubbornness or maybe it’s just the fact that by being at home there wasn’t any other option.  For those of you who birthed naturally, how did you manage the experience?  What got you through each contraction?  Please leave me a comment — I’d love to hear what works for other people.