Purpose of this site up to now

This page represents a departure for my site.  The experience of our fourth baby's birth, eleven months ago at this writing, has opened my eyes and broadened my outlook on childbirth.  As my ideas and impressions go, so must go my work... and thus, my birth writings will become more inclusive, more focused on what embodies "the good birth" in general, and the optimal natural birth in particular, and less so on the rarefied topic of naturally painless birth.

I have a feeling that up to this point, my site has come off as being extreme and "out there" in its assertions.  I sense that women have come to it, even those in the natural childbirth community, and have felt that since they could not agree or identify with its claims of naturally painless birth, the site has nothing to offer them.  But that sort of thinking misses the point.  My main goal in creating this site is, and has been, to affirm that naturally painless birth is real, it does happen, and that maybe we who have experienced completely (or mostly) painfree births, know something or are doing something that the rest of you birthing moms could do too, to have naturally easier, less painful, and perhaps even painfree births yourselves.

So in that way, my site has provided encouragement for those looking forward to natural births, assisted or not.  It has also provided validation for those wanting to affirm their own naturally painless births in a society that often scoffs at or doubts painless birth stories.  And though I have not given birth unassisted, in its own small way, my site has added to the groundswell of support for those who choose to do so.
 

So, why the change?

Previously I have written that painless birth should not be seen as "the be all and the end all", as a firm goal, in planning a natural, drug-free birth.  I feel that way even more strongly now after having given birth to our fourth baby.  That birth taught me that natural, drug-free childbirth can be beautiful and satisfying even if it includes some pain.  In fact, it was our best birth experience.  How can that be, when I have asserted that our other three babies' births were painless for me?

At the heart of every one of my labors have been painless uterine contractions, accompanied by painless cervical stretching. These sensations were at times very powerful, but never painful for me.  Because of this, I have steadfastly maintained that my laboring uterus has never caused me pain in and of itself.  Yet in spite of their being largely painless, our first three babies' births were not without their drawbacks.  Someday I may share those birth stories with you in more detail, but for now, I'll summarize. 

Each of our first two births took place in hospital, and though we were somewhat "educated" about birth, and thought we had carefully chosen a birth attendant who would be sensitive to our wishes, I ended up being subjected to a number of interventions that the staff convinced us were "necessary".  Some of these were pretty unpleasant, and many of them, such as my being confined to bed during labor and in the modified lithotomy position for pushing, certainly made those two births more difficult than they might have been otherwise.  Too, as I have written elsewhere, those births involved back labor, which demanded every bit of control and concentration I had in order to stay relaxed ("fighting" the back labor by tensing up would have caused much pain).  I remember those two back labors as very hard lower back pressure which came and went with each late first stage contraction.  Pushing was quite strenuous each time, because as I said, I was kept in the modified lithotomy position, with all my weight on my rear end, so that baby's passage was made much more difficult.  And for the grand finale, with each birth I was given a large episiotomy.  The second one was especially large, and it, combined with the pressure of the unnaturally hard, forced pushing, probably contributed to the development of a rectocele, which was diagnosed some months following that birth.

Our third baby's birth, while a homebirth and overall a great improvement over the first two, was marred by two things: first, we had an invited guest present, and while in many ways it was wonderful to have her there to help out and share the birth with us, in one way, her presence was a problem for me: I felt inhibited as I would not have felt, had only my husband and midwife been with me.  That sense of inhibition, of being "on display", definitely had a negative effect on my labor's unfolding.  I also had back labor once again, and I clearly recall it hurting this time, for my back had been injured during that pregnancy, so it was hurting even before labor started.  But that turned out to be not much of a problem, as I found the Back Labor No More!! technique relieved my back labor quickly and easily.  No, the other problem was that I got to experience yet another episiotomy, which made three out of three.  This was a bitter disappointment for me, as I had so not wanted to have to go through another postpartum time marred by the unpleasantness of episiotomy's aftereffects.  Our nurse-midwife knew this, and supported me in trying every physiologic birthing position we could think of, to no avail.  I simply wouldn't stretch more than about halfway.  Now this could have been in part due to my sense of inhibition, but it also definitely had to do with my being excessively tight and toned "down there" - even after two vaginal births.

So you can see that my first three labors were anything but easy.  Plus, for various reasons, the joy and freedom that should ideally be present during childbirth were missing each time.  Still, I did get to experience one aspect of naturally painless birth (painless contractions), even if those births weren't especially easy (mainly because of the back labor).

In comparison to the first three times, our fourth baby's birth was truly a dream birth.  It took place at home, in peaceful privacy, with only my husband, midwife and children present.  It unfolded at its own, natural, relaxed pace, and ended with me being able to push our baby out without the "aid" of an episiotomy.  Afterward, I felt a sense of joy and accomplishment, instead of feeling dispirited and in pain from a surgically cut bottom.

I have realized a few things since finally learning for myself that birth doesn't have to be totally pain-free to be glorious and fulfilling.  To many of you reading this, the following ideas will seem obvious, but they should be food for thought for at least some of you, especially any who are first-time pregnant moms.  Here are some of my post-birth reflections, not in any particular order:
 

Painfree is great, but a positive, realistic attitude is even better

Before I go on, I would like to reaffirm my original definition of naturally painless birth, which reads

...by "naturally painless birth", I mean one that is spontaneously painless, from beginning to end.  In other words, the mother experiences no bodily pain, from the first contractions, to transition, to pushing, to crowning and afterward.  She may well feel very intense sensations, but they are not painful to her.  Or she may feel nothing at all, or very little.  Or she may feel intense pleasure throughout, especially as baby emerges.  And all of this is accomplished without drugs, elaborate breathing techniques, focal points, or any of the other artificial props that our culture uses in an attempt to make birth "easier".

I stand by this definition and feel that it is accurate, and affirm that naturally painless birth is the ideal.  I do not, however, feel that it is something toward which we must single-mindedly strive.  If you have a naturally painfree birth, great, but if you do not, it would be a shame if you were to see that as a defeat or let-down of your expectations.  That can in turn pave the way for postpartum reactions, even depression.  It is not worth it.  Better to accept the birth you get, after preparing by way of the best birth attendant, birth place, etc. that you can arrange.  This is assuming the birth goes optimally, with maybe some passing pain or some unexpected development that required a bit of help to resolve.  If the birth does not go so well, say, things happen that could have been avoided, try to view it as a growing experience, and take what you have learned into your next birth to help ensure that you will have a pleasanter and safer experience next time.

Just going by the small number of painless birth story submissions I have gotten, as well as the paucity of naturally, spontaneously painless birth stories online and elsewhere, I feel that naturally painless birth is a small minority of all undrugged births, and it may indeed not be possible for many women to experience (or some would say, achieve).  That is OK.  As I have learned first-hand, although perfectly painless birth is ideal, you can still have a perfectly beautiful birth that includes some pain.  We have to allow ourselves this so we don't feel let down if we do not experience that painfree birth that we had envisioned.  I reject such self-defeating talk as, "Your birth was not naturally painfree because you were [pick one or more] inhibited, fearful, lacked faith, or [whatever]." That puts all the blame on the mom, and messes with her head just when she most doesn't need her head messed with (she has enough on her plate being postpartum, caring for a new baby, etc.)

However, that should not dissuade you from striving to have the safest, most comfortable, most physiologically-friendly birth you can achieve. As an added bonus, it may turn out to be naturally painfree.  Painlessness is not a guarantee of unhindered birth, but it can be a "perk" of same.
 

Painful or painless?... What really matters

Pain can be caused by one or more of the following:
medical intervention or procedure,
poor positioning of mother,
fear/tension in mother,
baby in less-than-ideal position (e.g. arm up beside head during pushing),
previous injury in mother, such as lower back strain...

or because it simply hurts, mother perceives it that way, even though she may have been trained to relax, etc.  For many women, the sensations of active labor (particularly during late first stage) are enormous, and it is difficult to interpret them as anything other than pain.  Much of this has to do with our cultural conditioning ("birth is always painful"), but I think it is wrong to deny that, depending on the woman, any given phase of childbirth may simply be perceived as painful, even under ideal circumstances.  For some, the painful part may be late first stage labor, when the uterus is working very hard to open the cervix those final few centimeters.  For others, the "ring of fire" sensation during crowning of baby's head, just before birth, may be felt as pain.  These are just two examples; there are probably others.  Certainly back labor is felt as pain in most women who have it.  Thankfully, most births do not include back labor.

I submit that both of these are wrong-headed assertions:

to say or imply that unhindered birth should never hurt, and that if it does, the woman must be doing something wrong;
      - or -
to say or imply that birth is always painful, and those who have "recast" the sensations of birth and labelled them or recalled them as being "intense", "rushes", "waves" or whatever word you want to use, are in denial of the true pain they (allegedly) experienced while giving birth.

How do we know what any given birthing woman has experienced?  Who are we to say what she should or should not have felt?  After my fourth baby's birth I truly understand a woman's birthright to claim and celebrate every recalled moment of her birthgiving, even those moments that were physically painful.  Why not, especially if the birth was, overall, deeply satisfying?  Why should a "good birth" not include a certain amount of pain?

I think the proper goal to aim for in birth is not a painfree experience, but a safe one for all involved.  What constitutes a safe birth will depend on the individual situation.  As I have noted elsewhere, for some mothers and their babies and pregnancies, "safe" means in hospital with medical personnel and technology at the ready.  For most others (though most women don't realize this or think it could apply to them), it means in a birth center or at home with a doctor or midwife who respects the birth process and knows to not intervene unless truly necessary.  And for some, it means birthing alone, or with just their mate and/or family present.  (A planned unassisted birth can truly be a safe birth.  For more information, see Laura Shanley's and Bob Griesemer's websites.)
 

Pain relief and comfort measures: what's natural, what only seems that way

Natural-seeming, but perhaps not instinctive, pain-relief/comfort measures:

use of herbs and/or homeopathy
waterbirth, waterlabor
belly-lifting technique to relieve back labor
massage, ice or heat to relieve back labor or other discomforts
active relaxation (total body)

I haven't used herbs or homeopathy during labor, or experienced waterbirth, so I will not comment on those options at this time.  I have already written that the belly-lifting technique is one that is learned and not one that seems intuitive.   There  isn't much I need to say on the uses of massage, ice and heat - these, too, seem to be learned, and they also generally require an assistant to carry off successfully.

I do want to touch on the subject of active relaxation.  This comfort measure I have practiced more (or less) successfully during all four of my labors.

I have a hard time believing that women at any point in history were naturally, spontaneously able to totally relax ("like the animals do") in the face of the typically overwhelming power of labor contractions.  Total body relaxation in labor, like successful breastfeeding, seems to be something that must, to some extent, be learned.  It has an instinctual underpinning, but our conscious minds can be very good at undermining or ignoring our instincts, especially in this birth-fearing, technology-dependent culture.  So expectant parents desiring to achieve "natural childbirth" are smart to seek out the modeling and instruction of others.  Women who have experienced unhindered labor for themselves are well-equipped to explain exactly why it's important to completely relax "as if your life depended on it" during strong contractions, and how best to achieve that relaxation.  Too, they may emphasize the importance of listening to one's body, of following the body's lead as to comfortable labor positions to assume, when to push, and so on.  Their instruction might be direct, for example by mentoring or classes, or indirect, by way of books or websites.  With such guidance, parents are then empowered to find and claim instinct-led birth for themselves and their babies.

Again, I know there exist births that are naturally, spontaneously effortless.  Likewise, I concede that some mom/baby pairs can achieve breastfeeding success with no help.  But we are social, we are self-aware and tend to "think too much";  and as women especially, we are prone to let our emotions rule us at times.  With all that, there can be no doubt that we birthing and new moms generally do best when we have help and support of some kind, as anathema as that may sound to many unassisted birthers out there (hereafter referred to as UC'ers, UC meaning unassisted childbirth).  After all, most of you UC'ers chose to UC based on what you read or heard from others about UC, is that not so?  I doubt that in this culture, many of you would have thought of UC all on your own.  Given the way we are, the minds we have, and especially the culture we live in, attaining truly "instinctual" births cannot often happen without some gentle modeling, instruction, encouragement, guidance -- call it what you will -- from others who have gone before.

Most instinctive-seeming ways to achieve comfort:

seeking quiet, privacy, and possibly darkness
position changes as needed
moaning, sounding as needed

I say these are the most instinctive-seeming ways because they don't require any special equipment or help to achieve, and studies have shown that one or more of them spontaneously arise in birthing mothers who are in a supportive, noninterfering and noncoercive environment.
 

Thoughts on instinct and birth

Lately I've been reflecting on the question of what exactly constitutes instinct during childbirth.  I recall that I seemed to have had a distinct lack of instinct during our most recent birth.  No, that isn't quite right.  I did perceive and heed those instinctual promptings.  Some of them surprised me, as they went against what I had read and learned, and had even written on this site.  I guess when I say "lack of instinct" what I really mean is "conscious tentativeness in the face of bodily certainty".   I found that several times, though I already and viscerally knew the answer to a question (like "should I try changing positions?"), I wanted to hear that answer from our midwife.  I wanted that confirmation, that affirmation.  Maybe that is just the way my brain works.  Even as my deeper self surrenders and dives into labor, my conscious mind is wanting to touch bases with someone else, with my husband, my midwife.  Plunging into the depths of labor is something like swimming in a wave-tossed sea, and my conscious surfacings to double-check my bodily signals are perhaps my lifeline to the shore, to my husband and midwife standing by in quiet observation and encouragement.

Why this desire for the support of an "other", an outsider besides my husband, especially when I have repeatedly talked up "the birthing instinct" on these pages?  Maybe it was because my instinct, or inclination, or personal "bent" at the time was to seek the input of my midwife during labor and birth.  I sense that if that was true of me, it must be true of countless other women, whether they have chosen to birth in hospital with a doctor or midwife, or at home with same.  That is because most of us do in fact seek some variation of the "wise woman", be that a mentor, guide, midwife, doctor, nurse, mother, or whomever, to come alongside us during our births, to help us keep on track when labor gets very intense or when we start to lose focus.  And what, after all, is so bad about that?

For years I have steeped myself in the writings of women who have chosen unassisted birth, who strongly feel that the presence of others, especially midwives or doctors, can only be a hindrance during birth.  And I agreed with their line of thinking, even wrote that all women ultimately needed was their own instincts to birth successfully, if they would only believe same.  I no longer feel quite that way.  Maybe it is true of a few women, but it seems to me that most women want and appreciate the presence of a birth attendant, whether it's their first baby or their fifth, whether they live in a high-rise or a rain forest, and whether we're talking now or four thousand years ago.  I sense that laboring mothers' preferring someone to be with them borders on the instinctual, and that this is a valid, natural and quite human desire.

As sympathetic as I am to the cause of planned unassisted childbirth, I feel that it is the unusual couple who chooses to go that route.  They have supreme faith, confidence, assurance, and certainty that this is the way they should give birth.  The mother is positive she can do it without outside help or meddling. In fact, she probably sees any outside help as meddling.  Many times it can be, especially in the West, where birth has gotten so managed, mechanized and medicalized.  But in many other cases "help" is just what the word implies, particularly for the first-time mom who has yet to experience labor.

~~~

The long and short of it is, I will maintain the original painless birth content on this site.  I will post additional painless birth stories as they come in, with the writers' permission.  But I will take a step back from what may have unintentionally come across as my hard-line stance on painless and unassisted birth.  I hope to post additional articles that reflect my changing views, or that take on other topics, such as iatrogenic (doctor-caused) caesareans.

I welcome your feedback.  Please click on the mail button below if you would like to send me your thoughts.