By Alyssa Colton
Issue 138 - September-October 2006
When I think of pain, I think of something shooting, unendurable, wrenching—something that is a shock to the system. I think of something that needs to be stopped at all costs. When I set about preparing myself for my first daughter's birth, I understood that pain was involved. Though on some level I was scared, I think I was more scared by all the medical horrors that could happen. As I did more research, I understood that many medical complications are brought about by the practice of medicine itself.
I knew that I wanted to have a natural childbirth, though I allowed for the possibility that I might want drugs. Still, I wanted to do everything I could to avoid that possibility. So I read. I read mainstream books, such as What to Expect When You're Expecting, but, thankfully, I also read Barbara Harper's Gentle Birth Choices, which made me aware of the history and politics of birth in the US. I found other resources of reliable information about the reality of childbirth. While no one could assure me that there would be no pain, I became reassured that the pain would eventually end, and that it was "pain with a purpose."
However, after going through the experience of labor and birth, I hesitate to call my experience of labor painful. It was extremely difficult—I had a very long labor that seemed to slow as the sun came up on each successive day. It was physically challenging because I couldn't get a full night's sleep. And my experience of labor certainly wasn't comfortable. Because of the way my baby was positioned, the pressure on my lower back was enormous—I was thankful anytime anyone applied pressure to it. But I found that labor was less like being torn open than like having someone regularly and rhythmically press against my insides.
In describing the experience of the body in labor, words such as cramps and contractions seem more precise than pains. Perhaps, for some people, these words aren't strong enough to evoke the extreme experience that labor can be; perhaps, for them, pain is the only word that adequately describes labor. But for me, a writer always in search of the right word, pain just doesn't quite fit. It's not that I'm trying to downplay the physical challenge of labor: I am trying to be more precise. My body felt more as if it was stretching and contracting than receiving shocks of pain. This kind of description seems milder, but it also seems more accurate and more hopeful.
Pain doesn't seem to be the right word to describe the body's natural preparations for birth; the experience of pain is nonspecific, uncontrollable, irrational. Contractions and an alternative word, rushes, describe more accurately the regular rhythms of the body in labor. If I were to describe any part of my experience giving birth as painful, it would be the sensations when my midwife began repairing my perineum, which had torn in all my hard work of pushing out my baby's rather large head But this pain came later, after the birth, and it was pain connected to a medical procedure rather than to a natural process.
Where does the term labor pains come from, anyway? I know the Bible speaks of the "pangs" and "pains" of labor, but Biblical thought also holds that these pains are God's "punishment" for Eve's sin. The definition of pain in Merriam-Webster's Collegiate Dictionary, Eleventh Edition reveals that the word is connected to Greek and Sanskrit words for punishment and revenge. Two of the definitions of pain are "usually localized physical suffering associated with bodily disorder (as a disease or an injury)" and "acute mental or emotional distress or suffering: GRIEF." Another, not much more comforting definition of pain is "one that irks or annoys or is otherwise troublesome—often used in such phrases as pain in the neck." The plural pains merits two definitions of its own: "the throes of childbirth," followed by "trouble, care, or effort taken to accomplish something." That last definition sounds like a better, more accurate definition of what women go through to birth a baby, and it takes away the tinge of punishment.
It's clear that the meanings of pain in our culture are a mixture of good and bad, of positive and negative connotations, though the word is more often used in its negative senses. Perhaps that's why we have the phrase pain with a purpose: to emphasize the definition of pain as "trouble, care, or effort taken to accomplish something." At the very least, what we need in our childbirth classes and books are reminders of this definition of pain. Without this kind of clarification, it's no wonder so many women are ready to sign up for epidural anesthesia before they've even gone into labor.
Simply put, how we talk about pain influences how we understand it, and even how we experience it. Midwives have also criticized the term delivery, because it takes away the woman's own work in the process. The phrase the doctor delivered the baby does not even recognize the mother as being present. Instead, some midwives prefer to say they caught a baby, a more descriptive and, it seems to me, more accurate term, because that is what a midwife literally does. How about the mother birthed the baby? That phrase reclaims the woman's agency in the process, recognizing her crucial role as more than just a vessel through which a baby is born. Think how powerful a message such changes in language would send to our daughters as they grow up. Think how differently they might come to view birth, how much more confidence they might have in their ability to do exactly what their bodies were designed to do. Some may say that language simply falls short of being able to describe such a deeply physical and personal experience as giving birth.
In The Blue Jay's Dance: A Birth Year, Louise Erdrich observes that perhaps "there is no adequate description for something that happens with such full-on physical force, but the problem inherent to birth narratives is also historical—women haven't had a voice or education, or have been overwhelmed, unconscious, stifled, just plain worn out or worse, ill to the death."1 In Spiritual Midwifery: Fourth Edition, legendary midwife Ina May Gaskin also wonders what social role language has played in shaping our understanding of birth. She addresses the words used for a woman's vagina and how these words are important in signaling how a woman feels about her body. "I tend to resist being told what words to use or not to use for my body parts," Gaskin writes. She decided to substitute different terms for vagina in her book, no matter how vulgar they might seem, in order to subvert the "crazy-making power" of language.2
Similarly, while I wouldn't advocate a complete elimination of the word pain from our vocabularies in relation to birth, I do suggest that women choose the words that actually describe their own unique experiences. I think that, especially in something like birth, we resort to language that has been handed down to us. It's easy to talk about dilation, stations, transition, and crowning because, as educated medical consumers, we've imbibed this vocabulary. But how well do such words describe each woman's personal experience of birth? Gaskin believes so much in the importance of language in shaping our attitudes toward birth that at least half of two of her books is devoted to women's birth stories, mostly of women who gave birth on The Farm, the community where she lives and works. The birth stories are provided so that women reading them can see that "birth can be ecstatic and strengthening" as well as "orgasmic."3Orgasmic—now that's a far cry from painful.
We also need to pay attention to the stories of birth that surround us. Before I got pregnant, the story of birth was, for me, a movie cliché: a woman starts labor, there is a mad rush to the hospital, and the baby is born, thanks to the divine assistance of medical personnel. Even in the stories of babies being born in cabs, the driver is the hero: the mother is just an unfortunate accessory, a helpless patient in a "crisis" situation. There is some hope, though; at least two TV shows I've seen in the six years since my daughter's birth have varied somewhat from this formula. In one episode of Judging Amy, a woman had a homebirth in a birth pool; on Friends, Jennifer Aniston's character, Rachel, rushed to the hospital only to find that her labor had slowed and she was just stuck there, waiting. Most helpful for me when I was pregnant was to hear and read the birth stories of women who had recently given birth and who, no matter how or where they gave birth, viewed it as an empowering experience.
I learned how many different kinds of births there can be, yet at the same time I learned how much birth is governed by the natural courses of the body—as long as the body is allowed to do its work. As I write this, I am pregnant for the second time. This time I feel less fear and more wisdom about the unpredictable nature of birth. I know that birth can be ecstatic—a word I hadn't understood in connection to birth before—as well as very, very difficult. That is why I rather like the term labor; to me, it more accurately describes the work the body does in preparing to birth a baby than the more passive enduring pain.
As I did during my first pregnancy, I am practicing prenatal yoga and relaxation exercises. I'm also working hard to prepare my body for the physical challenges of labor—trying to build up more endurance, as well as strengthening and preparing myself for the difficult mental work of labor. But unlike the first time, I don't think of these preparations as a way to steel myself against pain. I think of them more as a way of preparing myself for an extreme physical and mental challenge. I remember my doula telling me that it helped one woman in labor to be reminded of a marathon she had completed. I can't boast of having run a marathon, but I do know that I got through the challenges of my first child's birth. I may be in for another challenge, but this time I won't be thinking of it as punishment. It will be work well worth the effort—and the result.
1. Louise Erdrich, The Blue Jay's Dance: A Birth Year (New York: HarperCollins, 1995): 43. 2. Ina May Gaskin, Spiritual Midwifery: Fourth Edition (Summertown, TN: Book Publishing Company, 2002): 7. 3. Ina May Gaskin, Ina May's Guide to Childbirth (New York: Bantam Dell, 2003): xiii. Alyssa Colton is a freelance writer and adjunct professor of English. She lives in Albany, New York, with her husband and two daughters.