Labor Pain

The Perception of Childbirth Pain

It is true that it always feels like pain, but that proves nothing - ice against a naked back always passes for fire. Mark Twain

Is the glass half empty, or half full? While your perception of the contents does not affect the volume, it certainly affects your satisfaction with the contents.

The same thing can happen in labor. If you approach labor as if it were something to "suffer through," or as if the labor process has no value, you increase the chances you will react to labor with fear and stress. This can send you into a cycle of increased pain, which increases your fear which again increases your pain.

One of the problems of fear during labor, is fear can influence our perception of sensations. A woman who is fearful of pain will describe the sensations as much more intense and painful than a woman who is not fearful of the pain. It is not that the pain and pressures of childbirth do not exist for the confident woman; she simply interprets the sensations as more than just pain.

You can experiment with the effects of emotion on your perception of pain to find out just how much you are influenced by how you feel. Try one or both of these exercises:

Arm Raising

Hold your arms out at shoulder height and hold them there for a minute while a partner tries to push your arms to your sides (with firm pressure but not intending to cause injury) for 60 seconds. The first time, have your partner tell you discouraging things such as, "You can't do this. Look at how weak you are. It's only going to get harder. You might as well give up now. It's just too hard to hold your arms up. Nobody can do this."

The second time, have your partner try to push your arms down just as firmly, but while speaking encouraging words such as, "You are doing it! Look at how strong you are. It is almost over, hang in there you can do it. Keep going, you are almost there. You're very strong. You're doing it!"

Ice Cubes

Put an ice cube in a plastic zipper-seal baggie. Hold it in your hand for one minute without letting go or switching hands. The first time either tell yourself or have a partner give you discouraging feedback as above. Switch hands and try the experiment again with positive feedback.

After you have tried this, you can begin to see the subtle ways your body reacts to negative and discouraging feedback. As you consider your attitude about giving birth, pay attention to the negative or discouraging feedback you are giving yourself about your ability to labor and give birth normally.

Changing the Perceptions

Some women cry at the thought of getting a shot and react as if in extreme pain when getting one. Other women behave as if nothing is happening. All guesses of pain thresholds aside, getting a shot always hurts because it always stimulates the nerves to send a pain signal to the brain.

One reason some individuals are more composed and report less pain during an injection is their perception of the pain. Is the expectation for the shot to be terribly painful, or for it to hurt a bit and go away quickly? Is the shot seen as having value, or as nothing but a source of pain? Does the individual have control over the shot (placement, when it happens, etc.) or is the individual helpless in regards to the shot? Each of these perceptions of the pain will affect the amount of discomfort the individual feels.

Commonly, modern women prepare for birth with the expectation the labor will be a terrible experience. Movies, TV and books are full of stories that make great theater, but are no more a reflection of reality than King Kong or the Swamp Thing. When you go into labor with fear of the process, you increase the probability you will experience more pain.

You deal with different degrees of pain every day of your life, from the painful fullness of a bladder in need of emptying to the painful gurgle of an empty stomach needing filling. Even though you know these pains are coming, you are not fearful of them. Why? Rather than being fearful of the sensations that trigger a need to empty the bladder or fill the stomach, you understand these feelings are giving you valuable information. You have learned to interpret these signals and respond to them appropriately. In short these discomforts have value to you.

You can also learn to understand the sensations of pain in labor and use them to make changes during your labor. Remember, labor is not something that happens to you, it is something you do. You labor when you respond to the sensations in your body to help move your baby out. This will not remove all the sensations, and will not guarantee you will not feel the sensations as pain. However, if you are able to remove your fear of what is happening and respond to your body's signals you are less likely to be overcome by the pain.

Finally is the control issue. Women who report the highest satisfaction with their birth experience are women who were part of the decision making process. Labor was not something someone did to them, it was something they did. Knowing you have other options and having the freedom to select the best one for you can increase your confidence in your labor abilities. Interestingly enough, feeling of control is a strong predictor of satisfaction with the childbirth experience.

References

Goodman, P., Mackey, MC., Tavakoli, AS. "Factors related to childbirth satisfaction." J Adv Nurs. 2004 April; 46 (2): 212-219.
McCrea, BH., Wright, ME. "Satisfaction in childbirth and perceptions of personal control in pain relief during labour." J Adv Nurs. 1999 April;29 (4): 877-84.