Does birth hurt?!
Well, its the question we all want to know when we get pregnant isn’t it! I mean, I guess based on everything that we have watched on TV, read in the media, and have been told by family members or friends, the odds don’t feel too good. But is this true? Is birth really as awful as shitting out a watermelon?!
Firstly, I think it is important to highlight that we are feel pain differently. One particular person (someone like me, as I am a wimp!) could feel pain from a paper cut, whereas another person might not even be aware they have broken a bone. Labour and birth can affect people differently too and there is various factors that can make it birth better and worse. I will unpick some of these in this blog.
Pain is a funny thing really, as often it is seen as a negative thing. In fact, I just googled it because I was curious. The first definition that came up was ‘An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage’ on the IASP (international association for the study of pain). Straight away, it is perceived as bad.
But actually, if I broke my leg, the pain in this would stop me from using it freely which is the bodies way of protecting that injury from getting any worse. Pain in this example is a communication to us to protect us. Surely that’s helpful, right?
What about pain from exercise? The harder you push yourself, the worse it can feel, but this is seen as for the greater good and therefore worth it. This is a productive pain as it betters us and pushes us to be better. My boyfriend used to shout at me ‘sweat is just the fat crying’ whilst we were training our half marathon many years ago. It always used to make me laugh, but ultimately it was about turning the narrative round.
So, is birth painful? I would say for some people, yes. For some people, it is probably quite horrific. If our core belief is that birth is painful, then it can become a self-fulfilling prophecy. You believe it will be painful, you feel a pain from it, so your body tenses up, making the pain feel worse and you end up in a vicious cycle. This concept is also known as the fear - tension - pain cycle. But this doesn’t mean it HAS to be be painful.
Is there any other normal bodily function that is designed to cause a human pain? Is it painful to eat.. nope. Painful to sleep… nope. Painful to see? No! So, this makes one ponder that surely the female human body is capable of birthing a baby without being in excruciating agony?
Let’s take a little look into the science behind how birth works. Hang tight, because this can be a bit confusing!
The brain has lots of different parts, but the one we want to focus on for birth is the autonomic nervous system, also known as the ANS. This controls various bodily functions for example - breathing, heart rate, reproductive organs and digestion. The ANS is divided into two parts; the sympathetic nervous system and the para sympathetic nervous system.
The sympathetic nervous system is the ‘fight or flight’ part of the brain, which I guess most of us have heard of. But in case not, what this means is when the body perceives (and perceive is the key term here) a potential danger or threat, it will enter into the sympathetic nervous system, ‘fight or flight’. This pumps up our stress hormones (cortisol and adrenalin), and makes us hyper alert, ready to act. The history and biological reason for this, dates back to the cave man era. Back when humans were living in the caves, living off the land, ‘fight or flight’ would have been essential to maintain life. If a bear approached, looking hungry and baring their teeth, the caveman would need to act quickly in order to survive. Survival of the fittest.
The other part of the ANS is the para sympathetic nervous system. The para sympathetic nervous system is also divided into two parts - the ventral vagal and dorsal vagal. The dorsal vagal is where something does not feel safe. In fact it is so unsafe, that even ‘fight or flight’ don’t seem the appropriate response either. So we just freezes and do nothing. A great example of this is something you’d expect to see on David Attenborough. The lions are chasing some gazelles and one of them catches a gazelle and pulls it down to the ground. One of the strategies the gazelle uses is to ‘play dead’. They freeze. So much so that the lion is happy they have succeeded in killing it, and off they go to go and get the rest of the pack. The gazelle takes this opportunity to jump out, shake out their limbs, and run off having very narrowly escaped death!
The ventral vagal part of our para sympathetic nervous system is our safety response. This is where the brain goes when feeling safe. For example, being in your home or being in the company of a loved one. This is where our bodies work their best. Those bodily functions the ANS controls, can function at their best standard.
Whilst this is all very fascinating, what has this got to do with birth? So, our body is seriously clever, and unless we are in our ventral vagal (pop quiz - which part of the brain was this? Yes, you got it! The safety response), then our reproductive organs and birthing systems will not be working to their maximum capacity. A little bit like when you’ve had a puncture on your car tyre and the replacement is on so you’re limited to driving at 55mph. Depending on the severity of whatever the situation, they brain may just turn off certain bodily function, like our ability to birth the baby.
We live in a modern society though, and it doesn’t take much for the regular human to flick from their ventral vagal to be in the dorsal vagal, or ‘fight or flight’. I mean, christ, all I need to go into a full blown melt down is for me to get a letter in the post in a brown envelope!
I guess the point here is that if we can flick out of our ventral vagal so quick, then this can occur a lot during our labour meaning that our birthing systems are not working to their maximum capacity - and this can be very painful.
Common things birthers have noted that can trigger spikes in those pesky stress hormones (adrenalin and cortisol) in labour can be things as simple as a car journey to hospital, a worried expression on their doctors face, hearing emergency call bells in other hospital rooms or forgetting their favourite pillow at the hospital. So imagine then, if birth gives you a curve ball or things aren’t quite going as you had hoped or planned.. this has the potential to cause major set backs…. UNLESS, you are prepared for this, and can then be ready to try and reduce the severity of this.
The hormones needed for birth are pretty cool. We’ve chatted a little on the stress hormones, and whilst in modern society they can seem kind of annoying, back in cave men days they were essential to survive. Equally, they have their role in labour when we transition from active labour to pushing, but that’s a story for another blog! Let’s talk about oxytocin, because this is an interesting one when it comes to labour being painful.
Oxytocin is the hormone that really gets labour going. This is what enables it to progress as quickly as is possible. So what is oxytocin? This is the love hormone! It is a shy hormone and hides when not feeling safe. The only way to ensure the oxytocin is flowing is by feeling safe and secure. Things that can help encourage it are things like kissing, cuddling, orgasm, nipple stimulation, laughter, looking through happy memories in pictures and videos and eating heart warming foods. So, in the debate of ‘does birth hurt’, it’s interesting that the hormone needed to progress labour requires a feeling of safety and security to flow? As typically, and pain, safety and security are not usually associated…
What about endorphins? These are natures pain relief. When labour is able to gradually build (as typically natural labour does develop) would be able to feel some benefit of the endorphins which apparently can be 200x more effective than morphine!
When you spell it out like this, it doesn’t sound like the bodies natural function is designed to cause so much pain. So, when did this natural function go from being functional, to being terrifying, dangerous and agonising? It is difficult to say really. Years ago, when medicine was far less advanced than today, there was lots of unsafe practice going on which ultimately did make it dangerous. Times aren’t like this now though, giving birth is safe. Statistically speaking that is.
Hypnobirthing focuses a lot on ways to maximise the bodies built in functions designed to aid birth as a normal bodily function. There is a lot to be said for hypnobirthing as has been proved by research. Simple (2011) found that those who completed hypnobirthing were actually less likely to use pharmacological pain relief, were more relaxed in labour and therefore could actually enjoy it! Catsaros and Wendland (2020) found that those who did hypnobirthing had less fear and felt more in control which led to less pain.
Another consideration is the type of labour/birth you have. Inductions seems super common these days and I think there is lots of debate to how useful they actually are for non-complicated pregnancies. Again, better not go on on a tangent on that, or we will be here all day.
Spontaneous labours have better reported pain control from birthers. The body when left to do it without medical intervention, builds up gradually. However, inductions can cause labour to come on quickly and doesn’t give the bodies natural functions the chance to do their thing! Sara Wickham (2014) wrote a really interesting piece about the increase of pain in inductions and states that its not like normal labour. Between 2010 and 2021 inductions have increased from 21% up to 34%. Often inductions are offered because of something that might happen.. the quality of evidence to state whether this does actually make a positive improve on the risk is pretty poor in reality though.
I guess the thing with birth is it can be painful, in fact it could be very painful. But, the important message here is, it doesn’t have to be. There is a strong evidence based of strategies available to help control pain in our modern society. Equally, our mindset counts for a lot. What about if we change our perception about birth. Rather than cloud your mind with doom and gloom horrible traumatising birth stories - how about we flood them with positive birth stories? You’d be wowed by the magic of the brain. Feed it the right bits of information, and see the wonders of how it can turn something around.
I felt totally wowed by all this information on hearing it. It totally makes sense, but it couldn’t be less from common knowledge. Understanding this was massive in changing the way my mind percieved birth. If you feel the same, click below to get onto one of my courses for more wow science!