Is it possible to have a pain-free labour???

It is 4:30 in the morning and I’ve been up for at least an hour, tossing and turning in bed. My baby has also been tossing and turning inside my belly.  Since I can’t seem to find a comfortable position, and I’m a bit hungry, not to mention gassy, and I don’t want to ruin my husband’s night, I’ve decided I might as well get up and do something productive.

My most recent middle-of-the-night musings centered on my upcoming labour. It’s only three months away and I’m more curious than anything else about how it’s going to go. I’ve never had a baby before so in many ways I don’t have any preconceived ideas.

Actually, that’s not true.  I do have many preconceived ideas – we all do.  If you’ve ever watched a movie or TV show with a woman in labour, if you’ve ever had a previous baby, if you’ve ever heard someone else’s horror story….then you have preconceived ideas.  Unfortunately, much of what we see in this culture is a hollering, out-of-control, fearful woman who is flat on her back, draped in hospital sheets, usually shouting cuss words at her man.  She pushes hard while the doctor yells PUUUUUSHHHH!!!!, her eyeballs and veins popping out of her head. Suddenly, you hear a cry and out pops a perfectly clean 15Lb infant who is placed in mom’s arms all happy and swaddled.  Dad comes near, or faints. Cue the sentimental music…….It’s all rather dramatic, and might I add, traumatic!

And that, ladies, is our culture’s predominant representation of childbirth!  Ideas translate to thoughts, and our thoughts inform our beliefs.  Beliefs and past experiences are all very powerful tools the mind uses, either to our advantage or disadvantage, to inform what might happen in the future.

I am greatly blessed to have actually assisted in a childbirth before! It was such a beautiful and empowering experience, and nothing like what I described above.  It was actually very simple. It was me, the mom, and the nurse. We were in a simple missionary hospital. The birth went beautifully and mom moaned in pain a bit, but there was no hollering or screaming (as per her culture’s expectations of displaying no pain).  While I had seen a lot of movies depicting out-of control women in the past, here I saw a real-life story of a mom in control, focused and at peace.  That just blew all prior preconceived ideas out of my psyche!

I know not everyone’s story is like that. It doesn’t always go so picture perfect.  But while we can’t control what happened in the past, it is certainly within our power to control how we will think about something. We can be positive or negative. We can be fearful or courageous. We can assume the worst or be hopeful for the best.  We can manage our thoughts and not let them manage us.  We have the power to choose.  We can choose our attitudes about childbirth and labour and delivery and thus, we can powerfully affect how our labour will actually turn out.

There is much research in the neurosciences literature to back up my last statement.  More than ever, researchers are understanding the central role the BRAIN has to play in…pretty much everything.  As a physiotherapist, much of my training centered on helping people manage or eliminate their pain by using the body itself or non-pharmacological modalities. So the emerging research on pain-sciences fascinates me!

So what is pain?

Pain is a good thing.  It’s a good thing in a normal, healthy functioning body where the system hasn’t been thrown out of whack.  By “out of whack”, I mean that the nervous system has become sensitized, and is no longer processing pain correctly. But let’s assume that you have a normal nervous system – which is made up of the brain, spinal cord, and nerves.  In a normal system, pain is a good thing.  It’s designed as a warning system to get you away from something potentially dangerous or threatening.

So what is the definition of pain?

Most people believe that there is a “pain” nerve that transmits signals to the brain when you hurt yourself.  You’ve probably seen the classic photo of someone touching a hot stove and a red hot line running from fingertip to brain.

It’s based on the antiquated idea that pain is produced in the tissues of the body. Unfortunately, our medical system still, despite so much research, centers treatment on this false notion that pain starts in body.  But if that is true, how do you explain the phantom foot pain of an amputee whose leg is long gone?

Pain is now being redefined by neuroscientists as something that happens in the brain. It has been called:
•       An “illusion”
•       An “opinion”
•       An “output”
•       The “sum” or “conclusion”
•       A protective “response to threat”

Basically, pain is thought to be a response generated by the brain and sent to the body AFTER the brain has processed ALL the information related to the sensory experience.  So it seems that we do not have such a thing as a “pain nerve” or a “pain receptor” in our body after all.  Our brain receives message about heat, cold, pressure, position, etc…but not about pain.  Pain is actually message sent TOP DOWN from central processing – ie. the brain.   It’s a two way street.

The brain will make a decision based on all the incoming information. It will decide IF you feel pain, and how much or little pain you feel based on the following things:
•       Sensory information (what you see, smell, taste, hear, and feel)
•       Your physical state of health (what you eat and drink and your fitness directly impacts this)
•       Mental state (angry, over-analyzing or informed and knowledgeable)
•       Emotional state (fearful, anxious, or happy and at peace)
•       Spiritual state (in tune with God or out of sync)
•       Stress (the presence or absence of cortisol)
•       Fatigue
•       Your beliefs and thoughts (why do you have pain, what is causing it, what does it mean)
•       Past experiences of pain OR hearing about other people’s past experiences
•       What medical professionals tell you (and the language they use) about your pain and condition, and more!

I hear some of you saying: “so you’re telling me that pain is my head?!”  Lol.  Well yes and no. It’s not all in your head! It’s very very real, but it is mediated by so many factors – some which we can control and others which we cannot.

When it comes to childbirth, our culture has taught us to fear it.  We are brainwashed to believe that it WILL be horrific. That it WILL be unbearably painful. That we WILL need serious medication.  That it’s OK if we lose control and swear at our husbands and everyone who comes into the room.   We are primed from the moment we watch TV, to be anxious about childbirth.

However, we can have a lot of control over how “bad” the pain is based on all the factors listed above.  I have heard stories of women who have had no pain during their labour!  I think it is actually possible, based on the science. But since most women will experience some degree of pain, there are many ways to minimize it: hypnobirth, water birth, and various breathing, relaxation or meditative techniques play a huge role. Positioning of the body and movement can help mediate pain, as can sensory input (ice, heat, TENS machine, acupuncture). Keeping fit and healthy BEFORE and DURING pregnancy goes a long long way in decreasing pain.  There are as many ways as there are women because no two people are alike.  You need to find what works for you. Don’t be afraid to explore and take back control.

For me, the best way I do this is to deal with my mind and my thoughts.  At 4:30 in the morning, when I feel fear or anxiety rising up within me, I review my presuppositions and re-focus on the truth: “my body was designed for this. Childbirth is very natural and normal. It’s not a threat to my system.  My body will do what my body is supposed to do. Don’t fight it because that will only make it worse.  Whatever pain I feel is pain with a purpose, so I can bear this. Breathe.  I want to be a feeling person and surrender to the full experience.  This pain and experience is not harmful to me.”  As I Christian, I meditate on the following scripture, stating that I have not been given a spirit of fear but one of power, love, a sound-mind and self-control.  This is my reality and it’s a powerful one.

Well, I could keep writing forever, but now it’s time for me to start my day.   If you have any questions about how The Mama’s Physio can help with pain control during labour, sign up for the Pre or Post Natal program – we go over all of that during session one!

Be your best.

The research is always evolving!  For more information about pain, see: http://www.noigroup.com/en/About
http://www.youtube.com/watch?v=4b8oB757DKc
http://www.youtube.com/watch?v=L4oy2LnoDZA

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ibbie here!

Just a physiotherapist with a passion for birth, pregnancy, postpartum, and pelvic health…and apparently the letter “P”.

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