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home birth

Considering home birth: part 4

What about the pain?

Whether you’re expecting your first baby or your fourth, it’s normal to feel a sense of trepidation when considering the actual birth. I remember very clearly being about seven months pregnant with my first baby and looking down at my belly that I knew would only get bigger and thinking, “this is really going to come out of me somehow?” I wouldn’t say I was in a full-on panic, but I was definitely worried.

Along with the normal maternal worrying is our cultural fear of birth, and we commonly hear expressions that lead us to believe that birth is the most painful thing that a body can experience.

Is it really, though?

I have a problem in my low back that is chronic, expected to get progressively worse as I age, and can sometimes be excruciating. I had one of these acute flare-ups a few years ago just before my daughter graduated from high school, and it was one of the most severe I’ve experienced yet. I cried at the thought of moving, going from sitting to standing, or standing to sitting. Bending down to pick up a dropped item was impossible. Getting in and then out of a car was a ten minute ordeal on each end. Pain was nearly constant, with no promise of an end, and I wasn’t getting a sweet cuddly baby out of it. As a person who normally avoids even common over the counter medications, I was willing to take any pain medications that were offered to me, so that I could begin healing. This experience was decidedly worse than giving birth by a country mile.

I’ve heard people describe other injuries that again make me question our notion that birth is the worst pain of all. My normally mild-mannered brother-in-law was not at all mild-mannered when his shoulder dislocated. The re-location procedure was probably a ten on the ubiquitous pain scale, given the colorful language that ensued during the event. Other medical and dental complications can be incredibly painful, and again, with an uncertain end, with the only reward in the end being going back to normal. A good imagination and a lengthy reading list that includes descriptions of war and violence, could lead any thoughtful person to see that the human body can and regularly does experience much more painful events than normal vaginal birth.

Is pain necessarily a bad thing?

If a friend were to tell you than she is training to run a marathon, you would not likely respond that she shouldn’t try to do it. She will probably experience some pain pushing herself to run farther than maybe she’s gone before. She may become injured training, or during the event, and she will probably be pretty tired after the race. Just the simple fact that she may experience some pain and discomfort would not be a reason to try to dissuade her from her desire to take on a big challenge.

Pain in our bodies is a message:

  • Take your hand out of the fire!
  • Get your shoulder back in its socket!
  • Your teeth need some expert care!
  • Good for you for exercising some unused muscles!
  • Take it easy so your muscles don’t get injured!

After many years of supporting women in pregnancy and birth, it seems true that the pain in their bodies is messages to them. Round ligament spasms, low back pain, and headaches remind us to stretch and exercise, be careful of how much and the manner in which we lift heavy items, and to stay nourished and hydrated. In labor, too, bodies speak and instincts listen. Contractions may make a woman get on her hands and knees and sway during them, which is brilliant for helping the body to open and the baby to descend. The myriad of sensations experienced during birth can help a woman to discern how far along she is in the process. And, sometimes her pain can signal that something is wrong and needs medical attention.

There is so much information in the world right now about the “right” way to be pregnant and give birth, and there’s a lot of moralizing around women’s choices. And, I must admit, at one time I felt pretty militant about un-medicated childbirth, and I was on a crusade of sorts to “save” women from pain medication. The truth of the matter is that on the scale of “Painless Orgasmic Birth” to “Birth Is The Worst Pain Imaginable,” most women’s experiences are somewhere solidly between the two extremes. (By the way, I support Debra Pascali-Bonaro’s work, appreciate her joyful spirit, and think she has a lot of good things to say). So, while I think that planning for a pain medication-free birth is reasonable, and have seen many women birth without pain medications, it’s also reasonable to consider that a positive outcome can be the result of a medicated birth.

In my experience, an un-medicated birth is more likely achieved with some preparation ahead of time. Preparation could include: childbirth classes, engaging the services of a doula, doing some soul searching, keeping yourself healthy, fit and hydrated, and being willing to accept the uncertainty of the process.

Taking a childbirth class, focused on natural birth is a great asset to a family expecting their first baby. It’s great to be in a group with other expectant parents, to hear their questions, and to begin to cultivate community. If you can’t find a local childbirth class, then do read all that you can, and your partner should, too, so that you are both on the same page regarding options and understanding what the process might look like. I still really like The Birth Partner by Penny Simkin. If your partner is only willing to read one book, make it this one.

A doula is a support person who is hired separately from your midwife to provide information and physical and emotional support during labor and birth. There is good evidence supporting the work of a doula, especially if your goal is to have an un-medicated birth with few interventions, and even if you are planning a home birth with a midwife. It is an additional expense, but I’ve not known a person to regret having this helpful and knowledgeable person available at their birth. There are many certifying organizations; take a look and see if any fits your personal philosophy and then see if there is a doula certified in that method in your local area. (Please note: the links provided are not an exhaustive list, only a starting place. I am not affiliated in any way with any of the linked organizations, and this is not necessarily an endorsement of their programs.)

Home birth is not for everyone; a bit of soul searching and understanding yourself might help you to decide if this is the right choice for you. How do you experience pain and sickness? Childbirth isn’t an illness, and it may not be the worst pain you can imagine, but you will likely experience some pain. Even women who describe their births as easy say that they felt pain. Do you have a good support system? Will you be able to relax in your home? Have you experienced past trauma, sexual assault, or abuse that may make pregnancy and childbirth additionally challenging? These are all great topics to take up with your care provider, your partner, and any other support person you will have with you for the birth.

Much has been written about keeping yourself healthy so that you can be as low risk as possible during your pregnancy and birth. I will not expound on that topic here; suffice it to say that nourishing yourself and your baby with good food, plenty of water, fresh air, relaxation, gratitude, and play can go a long way to experiencing your birth positively.

Labor and birth are an unknown, for every woman, every time. It is not a process that is easily controlled. In attempting to control it, we may alter it and create additional problems. While a medicalized birth experience may be right for you for many reasons, it is also worth considering if you want to embrace the untamed delight that can be home birth.


~photo credit Fox Valley Birth and Baby