Do attendants cause more pain during labor and birth? What allows for a pain-free bi

[IdentityCrisisMama]

Do attendants cause more pain during labor and birth?


What allows for a pain-free birth?


This is a spin off. Pain free birth has been something I’ve been curious about and I thought we could have a good discussion here about it.

TAO…

[USAmma]

I hired a doula for my last birth in case the epidural didn't work. I had total faith that she would get me through my fear/pain issues. I don't think I would have had a pain-free birth without the epidural but it would have been less painful with her support and guidance.

[homemademomma]

IMO childbirth hurts for a majority of women, whether they UC it or have hospital births. however, i definitely think that your attendants and your surroundings can affect the degree of pain you experience and your perception of it. you need to be completely 100% comfortable in your birth surroundings and your attendants, if any.

ETA i dont necessarily think that a "pain free" birth needs to be the ultimate goal. pain serves a purpose in labor, i think. it causes you to stop what you are doing and find a safe spot to deliver your infant. IMO, the ultimate goal is an empowering experience and a healthy outcome. my labor hurt a helluv ALOT. i wouldnt change a second of it.

[Rainbow]

What I said there:

Personally I believe it is a lot of "mind over matter" the reason some can walk on hot coals and be ok, while I can't bump my hand on the oven rack without tearing up. The more you practice, experience and focus on getting the mind over the pain the more successful you will be at pain free childbirth. *Believing* you know what causes the pain and eliminating that is just one more tool in getting your mind over the physical affects of your cervix dialating.

I think the pain of childbirth is not soley conditioning as some think- I think it is completely physical- nerves are affected and send signals to the brain. But ANY pain can be overcome.

Attendants adn environment certainly factor in to how we as the laborers process this pain and deal with this pain, but they do not (IMO) cause it.

[IdentityCrisisMama]

I guess, for me, I hoped for a pain-free birth. It seemed like I was hearing about a disproportionately large number of cases of pain-free birth while I was pregnant with my child compared with what the ‘actual’ statistics are (whatever that is :LOL)

I’ll admit that I secretly thought this would happen to me. It didn’t but the pain was quite intense and I really didn’t waste any energy being disappointed :LOL .

I think laboring at home and having planned a homebirth *helped* the pain. I also think that if I could ever get to a place of comfort and confidence to have a UC, this would also help the pain.

The pain was definitely there but the coping mechanisms were easier for me to get in touch with because of the planned HB.

My midwife didn’t help much for the pain but I imagine a better fit would have helped.

[thismama]

Originally Posted by homemademomma

IMO childbirth hurts for a majority of women, whether they UC it or have hospital births. however, i definitely think that your attendants and your surroundings can affect the degree of pain you experience and your perception of it. you need to be completely 100% comfortable in your birth surroundings and your attendants, if any.

ETA i dont necessarily think that a "pain free" birth needs to be the ultimate goal. pain serves a purpose in labor, i think. it causes you to stop what you are doing and find a safe spot to deliver your infant. IMO, the ultimate goal is an empowering experience and a healthy outcome. my labor hurt a helluv ALOT. i wouldnt change a second of it.

I agree with all of this 100%.

[Rainbow]

I also don't equate pain with bad... pain can be good. If you listen to your body pain tells us something important. Pain tells me to let go of a hot pan. Pain tells me what my body needs. In labor pain tells me what positions are best for me and my baby in our current situation, it tells me what I need to know to birth my baby.

[IdentityCrisisMama]

Oh, yea. My take on the pain isn’t necessarily negative. I’m telling ya’ I had this amazing woman tell me her theory of the pain of labor/birth. Her idea is that the pain draws others to support us and it’s monumental and amazing (painful as well) so that everyone is aware of the significance of what’s happening.

I think it’s a *good* thing.

Honestly, I can’t imagine just squatting my first child out. Part of me really needed the intensity so that I could really understand what was happening.

For me, having my first (and only) child was just intense…Earth shattering. It seemed natural that every emotion and feeling was the absolute most intense. Pain and all.









Now, this is *obviously* in RETROSPECT :LOL

[sevenkids]

I've talked a lot about my births on the intrathecal thread. Yes, your attendants can cause you more pain, if you're not comfortable or if you don't feel safe, whatever "safe" means. After 5 homebirths, I chose an OB and hospital for my 7th because the midwife I was referred to I detested, despised, could not tolerate a minute more. We almost came to blows because she told me my previous births did not happen at home, in Jamaica. (She practiced breifly in a birth center in Jamaica, and was convinced that NO ONE had a home birth there. I suppose I imagined it......... )

Yes, I could see birthing with her would be a nightmare! :LOL

I hired an OB who respected my wishes, (and was born at home himself) and I had a very enjoyable, unmedicated, un-interfered with hospital birth (with room service afterwards! Aaaaaah!).

I had 2 painless births, and honestly, I can't tell you why. :LOL

I chalked up my third birth, painless, 45 minutes, 10 pound 8 oz boy, to my being well educated, fearless, confident, trusting, ad nauseum. Then my fifth birth knocked the wind right out of my sails. My sixth, which during my pregnancy I was terrified and traumatized from my last birth, I went into with so much fear and negativity. If I had the option of a clean hospital with running water and drugs, I may have taken it! But she literally fell out of me, with nothing more than incredible pressure (of course). I never felt a contraction or urge to push.

So, I can't tell you why. I haven't unlocked the secrets of birthing yet! (and I hope I never get to the point where I think I know everything. That would be a sad, sad day!)
Attitude, fear, etc, all have a part in it, but they're not the only reasons.

[IdentityCrisisMama]

Oh, sorry, Rainbow…I didn’t even think of pain as an indicator of which position would be best. Yes, I can totally see that!

[homemademomma]

Originally Posted by IdentityCrisisMama

I guess, for me, I hoped for a pain-free birth. . .

I’ll admit that I secretly thought this would happen to me. It didn’t but the pain was quite intense and I really didn’t waste any energy being disappointed :LOL .

:LOL haha so did i!!! i always secretely thought that labor would be easy for me. when i was in labor, i remember thinking that natural childbirth was stupid and all women should get epidurals! good thing i was at home- im sure i would have gotten the meds if i was in the hospital. i am SOOOOOO glad i didnt have meds. i am such a birth junkie- i cant wait to do it again.

sorry : back on topic

[Yummymummy74]

"For me, having my first (and only) child was just intense…Earth shattering. It seemed natural that every emotion and feeling was the absolute most intense. Pain and all. "

I too think that birth is very intense! and it is earth shattering its amazing actually. I do think 100% painless labour is rare.. but then again define pain? many people have varying perceptions about it.. and I think the crux of it is (for me anyhow) that attendants bring their own hangups and their own opportunities for pain both mental and physical.

[IdentityCrisisMama]

Originally Posted by Marsupialmuma

and I think the crux of it is (for me anyhow) that attendants bring their own hangups and their own opportunities for pain both mental and physical.

Yea, no doubt.

I have a MW friend who practiced before having children of her own. She said that she thought attending to a birthing mother was *easier* before she had her own births. She said she now has a terrible time removing her own experience.





Regarding our perception of pain ~ Yea, I’m sure that’s a factor. Maybe what one woman calls ‘pressure’ I call excruciating pain.



When Aya was crowning, I remember my midwife (and other attendants ~ I transferred) calling to me to “push through the burn”. I felt *NO* burning sensation. That was strange that they thought they knew what I was feeling.



I also would love to birth again! It may not happen for me...maybe I'll get to be there for someone though.

[mightymoo]

I believe the pain women experience in childbirth is based on a number of factors - their own physiology (how in shape they are, etc), ability to relax, fear & tension and positioning.

I think that if we could look back to the way women birthed thousands of years ago when it was really completely instinct, we would find very little pain. But a lot of things have changed from then to now - Our bodies, while not evolutionarily different are used differently - we are out of shape so to speak (even if you are in shape, you probably keep in shape using your body differently than the women of that day) - we sit awkwardly and wear bizarre footwear, etc. I think all of those kinds of things contribute to our bodies carrying tension which works against us. I think some women naturally carry less of this, and so have less pain. Some women can study yoga, etc and learn to relax - others do manage to learn through birth classes, but there are a lot of us who cannot and a few weeks of breathing excersizes aren't going to change a lifetime of carrying tension.

Baby positioning probably plays some part as well. I truly believe we probably have a lot more posterior babies today than even 100 years ago becuase of the way we sit and recline. It's natural that there would be more pain on average when trying to fit the baby through the pelvis in a suboptimal position.

Where I think birth attendants can make a difference in that some are able to help a woman relax when she might otherwise not be able to - they can point out places of tension, etc. They can influence the fear & tension part of birth big time - either way, make a woman feel more relaxed or make her more nervous and afraid. However, the woman's own feelings of birth and her feelings toward her attendants are going to play a big role in their effectiveness.

So I guess I think that any woman could have a relatively pain free birth, if she is able to resolve her fear & tension issues, learn to relax, open up, etc. But I think for many women this is just not going to happen by taking an 8 week course and having a doula - it might take years of working hard at it to really be able to do that. I know I'm probably one of those women - I am not good at relaxing and I haven't worked hard at learning to relax and I haven't addressed my internal fears of birth and pain, etc.

Anyway, just my thoughts on the subject.

[IdentityCrisisMama]

Oh, yes, I do remember quite a bit about women who birth squatting and their ability to squat. Apparently, many of us don’t have that “skill” anymore.



I’d love to read something about the history of labor/birth pain. I always assumed it was just painful for the vast majority of births. Does anyone have any links?

[stafl]

I think our expectations make a huge difference, as do our perceptions of pain. I think fear can and does make pain a thousand times worse. Some attendents feed off that sort of fear, others help ease it. I think of pain as my body's way of telling me something is wrong. And, since I wasn't getting that sort of signal, nothing was wrong, it was all perfectly normal, I didn't have the same reaction to the "pain" of childbirth as I do to other types of pain. My contractions were more like belly squeezes than the pain I've heard other women describe. What did hurt was pushing past a swollen cervical lip, but by that point my body had taken over and I was just along for the ride.

[doctorjen]

I do think attendants can at least sometimes cause pain. I know I have, more so unknowingly in the past, but even now that I'm MDC-educated ( :LOL ), I still cause pain sometimes. I practice in an area where most women almost actively resist taking responsibility for their births. They expect me to be in charge and telling them what to do, or they expect pain meds. Sometimes I'm good at helping mamas with their pain, and sometimes I'm terrible at it, because their experience doesn't match mine and I don't know what to do, or we aren't a good personality fit.
In my own birth history, my first labor was quite intense and painful. It started with my water breaking, and contractions were immediately 2-3 minutes apart. Even though labor started so intense, because it was my first I remember still wondering if this was it, or was something else going on? After just a few contractions, though, the pain was enough to convince me this must be it. I remember having to focus so hard on my labor, I was almost completely unaware of my surroundings, and yet at the same time I have intense memories of odd peripheral things that happened (like my doc coming into the exam room in the office and scooping up my underwear and pad and sniffing them and saying "Oh yes, your water is definitely broken!") I barely remember the attendants around me, but I remember the sensations of that labor clearly. My ds was born just 6 hours after labor started, without pain meds or much intervention, and I was high for weeks after his birth with the incredible feeling of accomplishment. I had very minimal expectations for my birth attendant that time, and don't really remember much about him. In my mind, he was very peripheral to the whole picture and had little to do with my birth.
My second child, I was not satisfied with my planned birth attendants (a group of 6 medwives, with whoever was on call showing up to catch) I fretted and fretted over this during the last weeks of my pregnancy, and worried endlessly about getting one of the ones I didn't like. I had irregular, painless contractions on and off for 3 days finally, then had some bloody show, and a dull back-ache. I was planning on laboring at home as long as possible, then making an end-run. My dh offered to rub my sore back in the shower, so I got in the hot water and he rubbed for a while. I didn't feel anything in the shower, so I decided I wasn't in labor. Shortly after, my water broke, and my body was pushing. The only uncomfortable part of this labor was the trying to keep the baby in until we decided to forget trying to get to the hospital. I pushed once, with a sensation of blissful relief, and my girlie was here. I wouldn't describe any of this labor as pain.
The third was a lovely, attended hospital birth. Labor was more recognizable, but no where near the intensity of #1. I loved my family doc who attended this birth, and had no similar fear about who would show up at the hospital with me. The end of this labor was a little intense, but not bad at all. I felt very well supported and cared for, and really this birth was my favorite attended birth.
My fourth, you think I would have learned from my history that having an attendant I'm not comfortable with was not the way to go. However, due to circumstances too long to explain, I ended up using an OB I wasn't crazy about. This labor started like #3, but became intensely painful once I got to the hospital. I also stalled out for 2 hours or so, with painful contractions that just didn't feel right. I never had an urge to push, but pushed her out anyway because they told me too. At the time, I thought this labor was more painful because she was a bigger baby than my others, but looking back, I know that the pain was definitely intensified by fear of the OB and my lack of trust in her. In my mind, I have a vision of pushing this baby out on my knees, with just my dh doing counterpressure on my back, and my other kids ready to meet the baby. I won't have another opportunity, but if I did, I would either find an attendant I could truly enjoy having around, or UC on purpose.

[IdentityCrisisMama]

I think the expectation of *what* the attendant is going to do for you is huge. I know that, for me, I associate hospitals with sickness. I knew this was not something I could over come so I chose a HB.

However, I know choosing a HB attendant (trained MW) left me with a bias that I couldn’t birth without help. Just as birthing in the hospital would have left me feeling that birth was a dangerous thing.

This is how I think. The power if just being at home was huge for me. I imagine the power of a planned UC would be wonderful if it was something that *fits* with me.



OTOH, I can see how the ideal attendants have the potential to reduce pain.

[IdentityCrisisMama]

Originally Posted by doctorjen

I still cause pain sometimes. I practice in an area where most women almost actively resist taking responsibility for their births. They expect me to be in charge and telling them what to do, or they expect pain meds. Sometimes I'm good at helping mamas with their pain, and sometimes I'm terrible at it, because their experience doesn't match mine and I don't know what to do, or we aren't a good personality fit.

I can’t imagine how difficult this must be.


I know that I didn’t even know myself and what I needed for the birth. I was not entirely satisfied with my MW but I take the responsibility, yk?


I take it because I was shocked by what made me feel good during labor and birth. I thought I would want to be alone ~ wrong. I thought I would want to be in the bed ~ nope. I thought I would want the ball, birthing stool, hammock…~ nope.

[RiceMomma]

I too think that attendants can actually decrease the pain. (That doesn't mean that they can't increase it!) At my last birth, I delivered in the hospital with my husband, my MIL, my CNM and a nurse attending. When I would have a contraction, they would all put their hands on me, rub my head, my back, my feet, speaking softly and encouragingly. The love and support I felt, I cannot describe, but I can tell you, I felt safe, calm, and it didn't hurt as much.

But that's my experience. I'm sure there are women who don't want to be touched during labor.