Laurita Dianita

Reflections and art on the topics of public health, social justice, and love

Birth is Painful for a Reason. I am grateful for it.

with one comment

Moaning through contractions in the shower during Ida Luna's birth. All photos by Ash Adams.

Moaning through contractions in the shower during Ida Luna’s birth. Photo by Ash Adams (http://ashadamsphotography.photoshelter.com).

 

This is the conclusion I came to after giving birth for the first time in January of 2014, and have been thinking often about as I prepare for the birth of my second child this July:

 

Birth is painful for a reason, and for that same reason is a process that takes some time. When we embrace this, we can go into a deep and peaceful place inside ourselves, a place that shows us what we are capable of, and that shapes us as people and as parents.

 

This reason has nothing to do with divine punishment, nor with masochism (as is often the accusation against those who choose or advocate for natural childbirth). Of course, there is a wide range of how much time birth takes and how much pain the woman/birthing person experiences, but in all cases, birth is a process, an inherently challenging and revelatory and opening process.

 

I am not someone for whom mindfulness and a peaceful, non-worrying presence comes naturally. Nor has patience always been my strongest, most natural attribute. I am someone who moves through the world to make the world better. I am fiery. I am critical. I am eager and energetic to make change. And, like many other flawed human beings, I do not do this work with the perfect balance of compassionate curiosity and self-reflection and humility. My traits usually serve me well in my work to prevent violence, child trauma, and injustice and to improve systems and create cultural change. However, they also carry with them sometimes painful self-reflection and self-critique, excessive worry, and anxiety. Those things are not particularly helpful in labor – both because they can cause unnecessary suffering, and because they can interfere with the oxytocin and prolactin needed to open the cervix, pelvis, and vagina.

 

Two and a half years ago as I prepared for my first birth, aware that I have some traits and mental patterns that could get in the way during labor, I invested wholeheartedly into childbirth classes, books, and pain coping meditation practices, and I was gifted a blessingway ceremony. I did this because I knew I wanted a natural birth to avoid the effects of pain relief drugs on babies and on maternal oxytocin production for early bonding, and because of the increased risk of a c-section (that is, a major abdominal surgery) resulting from epidurals. I also knew I wanted a natural birth because I didn’t see how I could improve on what my ancestors have done since time immemorial, and because my mom, Barbara Norton, is a Certified Nurse Midwife (CNM) from whom I have heard my whole life about the beauty and transformative power of birth. Plus, as a bonus, non-medicated and particularly out-of-hospital births are a lot less expensive. What I did not know then is how grateful I would be for the kind of challenge that the pain and length of birth presented to me, the way it forced me into the deepest place inside of myself and the way that it brought me and my husband, Oscar, together and formed us as parents.

 

I should note, as a caveat, that I did not have what many would consider a particularly long or difficult birth: about 3 hours of early labor and 5.5 hours of active labor, including 70 minutes of pushing. However, ~8.5 hours of labor and 70 minutes of pushing out my giant-headed baby (her head really is big; it was then and still is in the 80-somethingth percentile) was painful and challenging, to say the least. And I am grateful for this.

 

In order to cope with the pain—which I felt in my uterus, hips, and low back, and which was exacerbated by a pre-existing back condition I have called spondololysis—and in order to encourage my cervix to open, I had to go inside myself, deep inside myself. I had to turn off my reactionary self, silence the parts of my brain that worry and experience fear, turn off my evaluator self and critical self and activist self, and just ride along with full faith and trust that my body and baby would do what they needed to do, and my midwives at Geneva Woods Birth Center would do what they needed to do (which I why I chose them—they are trustworthy). As it turned out, each of us did do precisely what we needed to do.

Holding Oscar and breathing in the early stages of pushing. Photo by Ash Adams.

In early labor, I used a Kundalini breath technique I had learned in prenatal yoga. Then I vomited some, but returned to my breath. As I moved into active labor, I used non-focused awareness, a technique I had learned from the book Birthing From Within and Jen Allison’s class, and later, I used visualization. I also breathed at a natural pace and exhaled with low moaning sounds. Meanwhile, Oscar soothed my body with the shower nozzle and hot water. As I danced my way into transition (the hardest part of labor, when the cervix moves towards complete dilation), I listened to the joyful Brazilian and Malian and Puerto Rican music on the playlist I had made, moaned, and held Oscar’s elbows and arms as he smiled at me calmly. As I pushed, I concentrated on baby’s head moving and my vagina opening, and I relaxed deeply between contractions and pushes as though I were lounging in a hot spring. As baby’s head burned my perineum, I focused on the elation of touching her head while it moved out (per my midwife mama’s advice) and knowing she would soon be in my arms. And then she was! I had gone into a deep, peaceful place inside myself so that I could minimize and get through the pain and so I could do my part in bringing forth her joyous entrance to life in the outside world, and my body responded by opening up and moving my daughter down.

pics_June2016_blog_on_birth145

After all that work, I had her in my arms. It was the most glorious feeling imaginable. Photo by Ash Adams.

In the months following, as my baby Ida Luna cried her newborn cries and Oscar and I had to navigate the unknown terrain of new parenthood, it became clear how this experience of having to go inside myself to cope and to find peace for labor had prepared me for parenthood. Having done it already while enduring the most intense pain I had ever felt, I knew I could return to peace and self-soothing while experiencing anxiety about my baby’s cries. This is not to say that I always did find peace in those trying moments, no no, but I did have my own example to follow. I soon learned that singing to baby Ida was the most effective way I could calm both her and myself.  As she got older and more emotionally and intellectually complex, Oscar taught her to ask for hugs when she would begin to have a tantrum, and this turned out to be the most effective way for Ida and us to calm down. We have multiple options now that we can offer her when she gets upset, but they all require us, as her parents, to calm ourselves.

 

Our ability to prevent Ida from escalating and our ability to self-regulate (calm ourselves down) and help Ida Luna self-regulate comes both from knowledge of child development and parenting, and from our confidence and practice in self-regulation and attuned, compassionate responses. Speaking for myself, it is not always easy and I do not always do it. I have never yelled at or threatened or hurt Ida, but I have reacted to her behaviors and cries with anxiety, confusion, and impatience, and I have snapped at Oscar in moments of anxiety over her. Unlike the one-day-only, high-stakes process of labor, when I was fully prepared and committed to self-soothing and focus and had the support to do so, parenting is a constant process—sometimes a slog—, and I am not always well enough prepared (or well-rested, well-fed, or well-supported enough) to check in and self-regulate. I am even less skilled at doing this when it comes to marriage, which I find is much more challenging than parenting. However, again, I do have my own example to follow, and I know that I can do it, and this does help me more often than not.

 

As I write this, I realize this discussion of self-regulation all sounds so scientific. I work in the field of child trauma and resilience, protective factors, early childhood well-being, etc. and so I think in terms like caregiver self-regulation and infant brain development, and see how my natural labor prepared me well for this most important of roles. But zooming out, I also think it’s bigger than this, more philosophical, more spiritual. I believe that the time that labor and delivery takes is an important process, a ceremony even, to move us from the long process of pregnancy into the much longer process of parenting. It is a liminal space between life stages, a ceremony of transition from one to the other. I also believe that coping with the intensity of natural labor teaches us (and teaches our partners or others who are there to support us) that pain and hardship need not lead to suffering; that freedom from suffering and a sense of wholeness is available to us even in the most difficult of moments.

 

Applying this specifically to parenting and all forms of caregiving for children, this ability to get through the really hard parts without suffering can help us to get through without blaming and shaming and hurting children, without turning to alcohol or drugs, and without disengaging and ignoring problem behaviors. If we can move through hardship without suffering and having to find an outlet onto which to throw our suffering, we can more easily raise children with dignity, peace, unconditional love, clarity, and consistent teaching and guidance. Given that early life experiences shape people indelibly on behavioral, neurobiological, and epigenetic levels, this is important. It is of the utmost importance.

 

_ _ _ _ _

 

In sharing my belief that the pain and process of natural labor can help us learn to cope with and move through hardship without suffering (a belief born from my own experience of birth and parenting and from the experiences of many others), I do not mean to imply in any way that natural birth is the only or best way to come to this kind of peace. Many people who never give birth are able, through many other means, to cultivate the peace within themselves to be fantastic teachers, health care providers, aunties and uncles, foster parents, mentors, etc. And clearly, many people who give birth via cesarean section or using medication are also able to cultivate these qualities by other means.

 

I also do not mean to imply that natural labor alone can be expected to alleviate all suffering, or to transform neurological programming for anxiety, depression, or reactivity that have resulted from childhood trauma or other risk factors. Even though birth can be deeply healing and transformative, typically other forms of support are needed as well to cultivate peace and healing. I certainly do not mean to imply either that the solution to intergenerational trauma and harmful practices of parenting and caregiving lies in individuals alone – these problems are exacerbated by and therefore must be addressed at the levels of policy, institutional structure and practice, culture, community systems, family systems, etc. Parents should be able to lead lives of dignity that are free from violence, make adequate wages, have maternity and paternity leave, and access social supports that support them in their parenting.

 

There are so many areas where change needs to happen in order to create healthy, happy childhoods for all human beings, and in my professional work I try to address every level of the social ecology  — from individuals to organizations to policy. But I do believe that our personal experience of birth is one of those areas where we can make a difference for parents and children. The reason I am writing about this belief is because we do not, as a culture or as a medical system, value this gift of birth; we do not value the pain and time of birth and what it can do for us as people and as parents. And because our culture and medical systems do not value it, we end up denying women/pregnant people and their families the opportunity to experience these gifts.

 

Without going into too much detail about it because it has been written about so eloquently in other places, the current US medical system (and those of many other countries as well) tends to push interventions and neglect to provide the compassionate, present, and evidence-based care and birthing environments that increase the likelihood of a natural, vaginal delivery. As a result, the national c-section rate is 32% and the percentage of births that include epidurals nationally was found to be 61%, according to a 2008 study, but can be up to 75% in some hospitals. The problem is not that c-sections or use of medication is inherently wrong or ill-advised in all circumstances; indeed, they can save lives and be the most compassionate approach. The problem is that they are over-used – with negative consequences for both maternal and infant health and even our maternal and infant mortality rates (which are among the worst in the developed world)– and that patients are coerced into them before and during labor. The problem is that patients are too seldom fully informed and empowered to make these choices for themselves and too seldom supported by providers to do so.

 

Very linked to the factors in the medical system is how our culture has come to approach and talk about childbirth and its pain and, on a broader level, other forms of pain and discomfort, both physical and mental/emotional. At least speaking of US American culture, which is what I am most familiar with, there is a cultural belief that we should be able to live free of pain and discomfort, that we are in fact entitled to do so. Heck, I like comfort and pleasure too, and I cultivate them in my life, so I understand why this is. The problem is when this reliance or over-attachment to comfort leads us to ignore or negate uncomfortable or painful problems (from global climate change and institutional racism to our own health conditions or dysfunction in our families) rather than solving them. The problem also comes when our reliance on comfort leads us to de-value natural – and often challenging – processes such as breastfeeding and birth.

 

If we do not understand what gifts natural birth can bring us, and specifically, what gifts are inherent in its pain – including the physiological process in which labor pain helps release oxytocin and endorphins that help progress labor and help us cope—, then we may think, as many who are preparing for birth do, “Why torture myself?” Partners and other supporters of a pregnant person may give them a hard time for considering a natural birth and accuse them of being masochistic or dramatic or “woo woo.” Healthcare providers, especially OBs, may talk women/pregnant people into unnecessary interventions, saying things like, “Why torture yourself trying to push out that big baby when it’s not going to work anyway?” The idea that birth pain is torture, the idea that it serves no purpose, the idea that it not only can but should be alleviated by external means, the idea that women/pregnant people are so weak that we cannot manage the pain with our minds and breathing and comfort measures and support people – these societal messages block us from experiencing the gifts of natural birth. These messages are harmful, both because they lead to worse health outcomes and because they reinforce the idea that pain and discomfort are equivalent to suffering.

 

Since parenting is full of pain and discomfort (and inconvenience, annoyance, sacrifice, fatigue, etc.), sending parents the message that pain and discomfort inherently lead to suffering and therefore are bad and should be avoided is not a healthy one. When people believe that their kids are making them suffer, they are more likely to treat their kids badly or to ignore problem behaviors while they get out of control. They are more likely to make “jokes” about how their kids drive them to drink (I see this all the time on facebook). They are more likely to place the responsibility for their own happiness onto their children, thereby giving their children an impossible job. And they are more likely, in some cases, to abuse their children. Again, I am not saying that if you get an epidural you are more likely to abuse your children. I am saying that the larger societal belief – of which our reliance on medical pain relief in birth is a symptom– that difficulty = suffering and that children make us suffer, that this is a belief we should do more to dismantle.

 

How about, instead, we as a culture embrace the idea that – to quote a punk song – “the only way through your problems is straight through them?” How about we see birth as ceremony and preparation for the life-long, challenging commitment of parenthood? How about we view and treat women/pregnant people as incredibly strong and capable, and create more opportunities to send them into the difficult work of parenting with this self-perception and a powerful birth experience to back it up?

 

Having experienced this kind of birth experience with my daughter, having experienced pain without suffering, I believe this equipped me for parenting her. It equipped me for hard nights of viruses, hard days of balancing work and meals and bedtimes, and guiding her to learn hard life lessons like how to share.

March 2015, nursing a very sick Ida during the layover of a very long day of air travel. Photo by Oscar Avellaneda-Cruz.

March 2015, nursing a very sick Ida during the layover of a very long day of air travel. Photo by Oscar Avellaneda-Cruz.

I look forward to returning to that deep place inside myself as I give birth to my son this summer. I look forward to the challenge of birth that is forcing me again to practice cultivating peace, and that will make me turn inward in labor and address my pain without suffering. I look forward to applying this lesson as we navigate the new world of parenting two children at once and cultivating healthy sibling relationships. Parenting, which is a mix of the glorious and beautiful with the mundane and the difficult, will certainly require this of me, of us.

 

I am so grateful to have had a mama-midwife and another midwife, a birth assistant, a partner, childbirth class instructors, and a social support network who believed this about me for my first birth. I am so grateful to have a birth team and others who believe it about me now as I prepare for this birth. I am so grateful to have friends share with me their strong birth stories and the faith and confidence and healing that was born in them as their children were born. I am so grateful that our bodies work the way they do, and that this process is perfectly built to prepare us for parenting. I am grateful that birth takes a while, and grateful that it is hard.

 

(A shortened version of this will appear on the Geneva Woods Birth Center blog in a week or two.)

 

Written by admin

June 6th, 2016 at 4:14 pm

Posted in health

Tagged with , ,

One Response to 'Birth is Painful for a Reason. I am grateful for it.'

Subscribe to comments with RSS or TrackBack to 'Birth is Painful for a Reason. I am grateful for it.'.

  1. This so eloquently describes my labor and birth experience. I like to call childbirth a “natural sacrament.” One of those times when monumental changes happen and the person ends the challenge is very different from the person who begins the challenge.

    Lauren

    7 Jun 16 at 8:23

Leave a Reply