Part 2 - Fear and Pain: A Cultural Picture of Childbirth...and What We Can Do to Change It

As discussed in Part 1 of this post, the experience of childbirth - and particularly the experience of childbirth as inherently painful - is strongly influenced by cultural perceptions and norms. In America, birth is largely defined by the culture-bound idea that pain and childbirth are inextricably linked. Insofar as thoughts and beliefs can impact personal experience, women who are told repeatedly to expect that birth will be grueling, difficult and painful naturally internalize these views (and the fears that result from them) over time and, thus, their birth experience could more likely be a painful one.

Challenging Our Views of Birth
If an understanding of birth as fundamentally painful and unpleasant can lead women to experience it as such, one has to wonder if this rule can be reversed. Are women who view birth as inherently comfortable -something to be embraced rather than resisted - and themselves as calm, confident and capable, less likely to have painful, difficult birth experiences?
This idea - that one can "deprogram" the mind of the cultural mindset that childbirth must be painful - is the basic premise of one particular approach to childbirth education and "pain management:" Hypnosis for Childbirth.

The Hypnotic Mind

Remember how in Part 1 I said that my own birth experience was virtually pain-free, drug-free and without any major medical interventions? In large part, I credit hypnosis for this.

There are two major hypnosis programs/styles that cater to pregnant and birthing women: Hypnobirthing (a.k.a., the Mongan Method) and Hypnobabies. There are also a number of childbirth education methods that utilize components of hypnosis. I used the Hypnobabies program for my pregnancy and birth with Little Man.

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Fear and Pain: A Cultural Picture of Childbirth...and What We Can Do to Change It

What if I told you that I gave birth to my child without anesthesia or medication of any kind, without any medical interventions to speak of...and the result was a childbirth experience that was virtually devoid of any pain? That I experienced childbirth in its fullest, most visceral state, completely comfortable and aware throughout the whole process? Would you believe me?

Allow me to digress for a moment, and ask you this question, instead: What is it about childbirth that immediately conjures images of screaming pain and terror? Why is it so difficult to believe that a child can be born peacefully and with minimal pain and discomfort?

The answer, it seems, is largely derived from culture-bound ideas about pregnancy and childbirth. Simply put, American culture - from popular media, to personal anecdotes - seems to emphasize that the birth of a child is inherently a painful and difficult process, wrought with potential dangers for both mother and child, and manageable only by those with the proper "authoritative knowledge" and understanding.

As the classic Brigitte Jordan book Birth in Four Cultures reveals, this view is not universal. Women in American culture are taught that this is so. They are told to expect that childbirth will be painful and thus, they experience it as such. For women in many other cultures, this is simply not the case.

This is not to suggest that women who experience childbirth as painful are somehow to blame for their experience, or that they are doing something wrong - far from it. The point is simply to ask how the American cultural picture of birth influences the way women in our country experience this fundamental life process. With fear and pain being interrelated phenomena - one influencing the other - does this expectation that all women are doomed to have an inescapably pain-ridden birth experience increase our fear and, thus, increase our perception of pain during childbirth?

How Fear Influences Pain - And What this Means for Birthing Women
For most, the idea of pain-free childbirth is quite foreign. While I've been interested for a while in the concept of "pain-free childbirth," I really started thinking about how fear can influence childbirth outcomes when I saw this article. The study described in the article examined mothers who suffered from severe or "excessive" fear of childbirth, and the impact of this fear on their birth experience. The main conclusion of this study was that women who suffered from extreme fear of childbirth were more likely to have epidural anesthesia, induction of childbirth, elective c-section, or emergency c-section.

According to the authors of the paper, and other previous studies (cited on page 4), the heightened levels of adrenaline that accompany a fear response can undoubtedly influence the progress of labor. Many of these women had had a previous traumatizing childbirth experience (and the phenomenon of birth trauma is a topic for a whole separate post I intend to write at some point in the future).

While the fear experienced by the women in this study was extreme, the results still raise many questions. Did the women's fear (and the neurological effects created by it) directly impact the progress of their labor, as the authors suggest? Were their care providers just more likely to undertake this type of intervention because of the woman's psychological state? Or is there somehow a correlation between the type of provider (one who is more likely to perform inductions and cesareans) and the experience of fear by their patients? It is difficult to pinpoint a specific cause-effect relationship here, and the study does not directly point to any one answer.

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