The following is an excerpt from Ina May Gaskin’s excellent book entitled Spiritual Midwifery. Ina May Gaskin is one of the leading midwives in the world today. Her birthing center boasts intervention and complication statistics that make hospital maternity wards green with envy. I would wholeheartedly recommend any of her books, most especially Ina May’s Guide to Childbirth, for anybody who is interested in natural childbirth and why and how it works.
I believe that much of the reason why the women whose births we attended were able to get through labor without anesthesia or tranquilizers had to do with the atmosphere we learned to create at a birth. There is a sound physiological explanation for why some women experience more pain in labor than others. A woman who is the center of positive attention, feeling grateful, amused, loved and appreciated, has a higher level of the class of neurohormones called endorphins. Endorphins actually block the perception of pain.
On the other hand, there are also adrenalin-like substances which may be secreted by the body during labor, especially when the woman is afraid, cold, angry, humiliated or experiencing any other disagreeable emotion. Adrenalin is part of the body’s protective mechanism when it is presented with danger; the heart rate quickens, the muscles tense, labor contractions may be inhibited, and the perception of pain is intensified. The mother is made ready to fight or flee when adrenalin levels are high, not to have her baby.
Much of the midwife’s (or husband’s or doula’s or labor coach’s — Réka’s note) responsibility during early labor is to give the mother so much positive, loving attention (and to encourage the baby’s father, if present to do likewise) that the mother’s endorphin levels are as high as possible. I learned humor could be a great help, in that it seemed impossible for a woman to be amused and afraid at the same time. The challenge then became (and still is) how to amuse a woman in labor. Naturally, this is a much easier task if you and she know each other well. It’s not easy to know what will be amusing to a stranger during the intensity of labor. Some women simply won’t think anything is funny, in which case, the main rule is to be soothing, sympathetic and encouraging.
The key to having a good labor experience is state of mind. Learning to relax and focus inward, to allow your body to submit to the sensations, and trusting that the process is a good one – that is key. I’m constantly trying to think of ways to prepare pregnant women – especially first-time moms – for the experience of labor. They are all very curious about what labor will be like, and many of them are apprehensive about the pain, and want to know about their pain relief options. From my very own labor experiences, I know that being preoccupied with controlling the situation, and being preoccupied with how many centimeters open one is (because epidurals are only given between 4 and 8 cm at most hospitals), greatly detracts from one’s ability to accept the pain and enter into that almost trance-like state of mind that allows labor to proceed most optimally.
At some point during labor, you have to make a conscious decision to allow labor to proceed, or to ask for anesthesia. This point usually comes around 4-6 cm for most women, when labor goes from the latency (early) stage to the active stage, and then contractions become more powerful and more regular.
If you make the choice at this point to proceed, it helps if the environment and the people in it can help you stay relaxed, feeling safe and loved. It also doesn’t hurt if they can make you laugh – though at this point, that may be a bit too much to ask.