Wednesday, September 29, 2010

The Price of Natural Childbirth

This post is for CM, MB and CC; friends who have recently given birth naturally.  They made it look easy.  But it wasn’t.  It just appeared that way.  If you can relate, this post is for you, too.
Lately, I’ve been directed to some YouTube birth videos.  The kind where the woman is screaming or, at the very least, protesting each contraction.  She’s in pain.  It’s more than obvious.  The comments that follow the video are sympathetic.  The woman is commended for having gone through the horrific experience.
One of my fellow teacher’s comments (about one of these videos) on our teacher forums got me thinking.  She’d posted the link along with the phrase: “NOT a Bradley mom!”  After watching only seconds of the video of this woman in early labor, I smiled at the validation that for once, someone else had the same perspective.

What’s your perspective?  Let me give you two examples.

Example one:  A contraction hits Mom; she writhes in pain.  Her face contorts.  Her hands grasp the bed sheets.  She screams.  She thrashes.  It is clear to any observer: she’s in agony.

Example two: Mom has a contraction.  She breathes deeply; sighs.  Her sounds are low.  She sways.  Her face is relaxed and peaceful.  It isn’t apparent that she’s experiencing difficulty.  An onlooker may not even notice she’s contracting.

What is your first thought? (Believe it or not, your answer to this reveals a lot about your preconceptions about labor and birth.)

If you said that the second woman had a higher pain tolerance or an easy labor, you have the perspective of the majority of Americans.

If you said the first woman is having a harder labor, if you said she was experiencing more pain, you may be right.  But not the way you might think.

I’ll give you my perspective: Mom #1 does not know (or is not proficient) in pain-reducing techniques.  She is not aware that her pain is exacerbated by her behavior.  She does not realize that position, tension, perceptions and expression can lend to more pain than she may otherwise have.  She is experiencing unnecessary pain.

Mom #2 is well-versed in comfort measures for labor.  She knows that doing all she can to get out of the way and allow her body to work unhindered will reduce her pain and finish the work ahead of her.  She works with the pain she does experience, and she sees it as good: the baby is coming.  Though her appearance is that of rest and tranquility, she is working.  Hard.  To relax.

This is how I see it.  This is how my fellow teacher saw it.

This is not how the general public sees it.

A woman who wants to give birth naturally might want to consider what it will cost her.  In order to assure the most success in her endeavor—indeed, the most enjoyment—she will need to give up her right to have a dramatic labor.  The better a woman stays relaxed and tension-free, the more it will look like she’s not even in labor (that is, from the perspective of the untrained eye).

Unknowing friends and acquaintances will not recognize all the work that went into the birth.  After the fact, whether her labor was long or short, word may get around that she just “showed up and had a baby.” Her providers may also be under this impression.  Even her husband may not realize how hard she was working.
It may be assumed that she is just “tough.”  Or worse, that she had it easy.  After  all, she wasn’t complaining.  And she didn’t look that uncomfortable.  It must have been easy for her.  She must be one of the lucky ones.

The woman who gives birth under the honed skills of relaxation may be despised by onlookers, hearers and naysayers.  She may reap the spite of other women; women will tell her they “hate her” for having an easy time of it.

Yes, natural, enjoyable birth has its asking price.  A price that is worth the time and effort necessary (necessary for all but the smallest percentage of women), but a price, none-the-less.  A woman would do well to consider and accept this likelihood when she starts on the path toward. . .

Enjoying birth.

Most woman can.  Few desire it.  Fewer succeed.

To my friends and loved ones who worked hard to prepare and educate yourselves for safe and satisfying births, I believe you.  I believe it was hard work.  I believe it wasn’t easy.  Congratulations on making it look so easy that people assume it was.

10/12/10 Edited to add this awesome link on birth sounds.


  1. Navelgazing Midwife just shared the link to your blog on her Facebook Fan Page. Awesome post. I can't wait to peruse your other posts.

  2. Thank you, Sarah! I hope you aren't disappointed by the rest of the posts on here! (I'm kinda nervous, actually.)

    And thank you for letting me know about the Facebook post. I'm a fan of Navelgazing Midwife. I actually used her "20 Years of Birth Stories" site to help prepare my mind for my 3rd birth. It really gave me a good range of expectations. What a compliment for *her* to refer to *me.* I'm honored.

  3. I absolutely love it! I find, at least in the hospital setting, that many women are simply not prepared for childbirth. I see many women whose only plan for labor and birth is to get an epidural. So sad.

  4. Oh, AYC's been here too? Well, I'm tickled. And honored. Thank you for commenting!

  5. You have some valid points here and it's great advice for women preparing for birth. However, as the owner of one of the screaming youtube birth videos, I feel the need to reiterate the point of just how different every birth is. I screamed so much during my second birth that I was horse the next day. My first, only one loud roar as he was crowning and my third very similar (though I'll admit, memories of #2 and the speed of labor lead to fear which I'm sure added to the intensity of the pain with #3.) even though the outside circumstance were very much the same. It was the position of my second son that made the difference IMO. I get comments about how if I were calmer or quieter or held my mouth different it would have been better. Which brings me to my second point: being loud or sounding distressed isn't always a bad thing! Yes, that birth was the most painful experience of my life, but I wasn't screaming because I was freaking out, or in a panic or anything. I wasn't thinking I was going to die. I wasn't thinking anything. It just came out in the intensity of it all (like an athelete grunting) It took me a while to get over being embarrassed by the noises I made, so I present these points for the benefit of other women out there who might be educated, well prepared and still loud in the labor room.

  6. Lia, your point is a good one, and one I don't think was very clear in my example of woman #2: I said something about low sounds. That may have implied she is quiet (which she may be), but what I meant by "low" was her tone, not the volume. The comparison was about the sounds being helpful, not high-pitched and tension-producing screams. Grunts and groans were what I had in mind.

    I agree with you. Sounding can be so helpful for labor.

  7. Sarah, great post! It sounds like you perhaps have personal experience with "having it easy" and such comments.

    "Pain with a purpose."

    I don't know if this phrase stays in the minds of most Bradley students (it didn't jump out at me until I was reviewing my materials to prepare for baby #2's birth), but telling that phrase to myself over and over again during contractions helped so much this last time. But you're right - it was a lot of work to keep focused and not let myself go over the freak-out edge. During transition I got very close to that edge, but thankfully my midwife reminded me to breathe deeply and slowly, and to make low noises. I felt like I managed labor much better this time.

    However, like Lia, I became a screamer when the pushing stage came. I don't think it was helpful, I'm sure it made things harder, but for some reason that was the only thing I felt like I could do, and it did feel quite relieving. Perhaps it was because I was no longer maintaining an "I'm in this for the long haul, so I need to conserve my energy" approach since I knew the end was very close - so I did what came natural. I'm not sure why it was that I handled labor so much better with number 2, but during pushing I was less effective than with number 1. Any thoughts are welcome.

  8. Taking a stab at it, Kar. By no means do I feel strongly about this: maybe it *was* the screaming that made pushing less effective this time. A scream lets air out that is better held in and used for pushing. I don't know if that may be it; it may be something else that has nothing to do with what you did (baby's position, station?). Which brings me to another thought: did you tear w/baby2? Because that "ineffective" pushing may have spared you a tear, even if it meant a longer second stage! I think sometimes we put too much emphasis on getting through labor efficiently. I'd much prefer to slow down and savor it (not that much savoring is going on when I'm pushing, either!).

    And second births do seem to be better for a lot of women. I think it's because we know a little better what we're doing.

  9. Oh, and in response to whether or not I have had encounters where my experiences were oversimplified, yes.

    But it's a fact that women in general who are well-prepared for labor get this kind of attitude, and it can be discouraging to have all that time and effort shoved into the category of "easy." I imagine you can relate, too.

    Actually, what prompted the post was thinking of comments I've heard lately that could be compliments or misunderstandings, depending how they are said. One woman e-mailed me saying that her birth went so great, the hospital staff was surprised she was so close to giving birth (and because I knew her, I knew it was a case of being well-prepared, not having it easy). And I'm waiting to hear from another woman how her perception of her first birth was (through the grapevine, I heard she made it to the hospital only an hour before baby's birth, which to some people means that she had an easy labor, but my first thought is, "Wow. She must have done awesome handling labor at home!").

    Don't know if you remember, but when Mom was in labor w/David, one of the guys from church stopped by and he didn't believe she was in labor (after all, she was playing cards!).

    Yes, I've had experience with such comments (and that's how I know how frustrating it can be) but I think it's a pretty commonplace thing.

    This post was also to remind women who have these things said to them (myself included)that those comments are actually compliments (even if the person isn't meaning them as such!) Come to think of it, maybe replying sincerely, "Thank you" would be an appropriate response to them!

  10. Yeah, that's a good idea - accept it as a compliment, whether it was meant as one or not.

    I actually thought about Mom playing cards through contractions while reading your post.

    With #2 I did have a very small tear. I think I didn't feel as much control over pushing in the position the midwife wanted me to be in. She had me laying on my left side so as to take pressure off of my right side where I tore pretty badly last time. So, even though I didn't like being in that position as much, it probably did save me a much bigger tear.

  11. The tragedy of this misconception is that women all over aren't aware that *they* are capable of having easy-looking labors, too!

  12. Since I'm the "fellow teacher" I'm going to weigh in on this. Making noise in labor isn't what I was commenting about. Many many many women make noise. They scream, they moan, they even get hoarse (I was after the birth of my 2nd baby). However, they do so just because it feels good to do it. Because it feels good to match that intensity with something else intense. As one wise birthing mama put it, "If you get the right vibration,the sound just moves you." However, the Youtube mama in question that I originally posted about was totally out of control--writhing and screaming and totally not knowing in the least bit what to do to help herself ... and the caption for the video is something like "early labor." No wonder women take epidurals in the hospital parking lot!

  13. Wonderful post! I had three births, all with some prodromal labor by the way, and I finally used hypnobabies with my third birth. BIG difference! Relaxing is hard work, but it does make birth so much more enjoyable. But like my mom said afterwards, there is nothing easy about an "easy" birth!

  14. Thanks for this post! As someone who did have a very fast, intense labor it is nice to have someone say "hey, it is hard, even if it didn't look that way!"

    I prepared for months, (although I didn't take a class because there was no bradley class in my area) reading empowering birth stories, contemplating the mechanisms involved in birth, and even when I was exercising, telling myself to relax through the effort I was putting forth so that I could do the same thing while in labor. My labor did start slowly, but progressed very quickly; we barely made it to the hospital and when we did she was crowning and born in 20 minutes. (5 hours total) My husband slept through most of it as I relaxed through each one and timed them. After it was over I forgot all about the pain during labor, but then my mom found the peice of paper that I was writing down the contractions, which looked a like this-
    1:30 am- painful
    1:36 am- really really painful!
    1:40 am- not so bad

    and so on. But I didn't feel the need to scream, because I knew what was happening was normal and necessary. There were a few hollars during transition, but pushing was a peaceful relief and quiet. My friends weren't that impressed, however, and just say "well you had an easy labor, but I....insert horror story". It's just not that simple.

    I am studying to be a doula because I want to be able to instill that kind of self-confidence in other women.