Friday, October 14, 2011

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.

What is known from other studies is that fear of pain can actually enhance and amplify the severity of pain. The more you are afraid that something is going to hurt, the more likely it is to actually hurt.

The question, then, becomes not one of whether or not childbirth actually is painful (surprisingly, most who say it is universally and inescapably painful are men), but how we can change the way we perceive and experience pain during childbirth.

I'll address this - along with the question at the beginning of this post regarding my own birth experience - in a future follow-up post.

Your Thoughts?
In the meantime, please let me know your thoughts! Do you think childbirth is inevitably painful? Do you think there is anything we can do to change the way women experience this fundamental life process?

Works Cited: 
Sydsjo,Gunilla; Sydsjo, Adam; Gunnervik, Christina; Bladh, Marie; and Josefsson, Ann. Obstetric outcome for women who received individualized treatment for fear of childbirth during pregnancy. Acta Obstetricia et Gynecologica Scandinavica: October 2011.


  1. I had a comfortable un-medicated birth, so I know it is possible. I also collect birth stories from moms using Hypnobabies at and many of them have comfortable births.

    But I do think most people find it hard to believe. It is so outside the information that media and society says about birth.

  2. I love this post and hope that many more woman read it! Some of the reasons I want to give birth while out on our Caribbean adventure is to get away from this culture's fear of pain, mistrust of birth outside a hospital, and the horrible stories women tell pregnant women about their traumatizing birth experiences. I really do want to use Hypnobabies while giving birth and have been kicking around the idea of compiling birth stories from women all over the Caribbean to understand the difference in cultural experiences. Hopefully, both of those contributions will make my birth experience as pain-free as your own with Lil' Man!

  3. A very belated 'thank you' for your comments! I'll be looking specifically at Hypnobabies in the next part of this post (when I get to it)!

  4. Thank you for your insightful post, Lauren.

    The staff at Hypnobabies hears from thousands of women each year who have had your positive experience with childbirth. Primarily because they learn to be more confident about childbirth while learning self-hypnosis techniques to create hypno-anesthesia. Also, more importantly, they become more confident and excited to give birth by instilling a new encouraging language paradigm, that creates a new belief system in their subconscious minds, about how enjoyable and comfortable birth can be...and it works beautifully for them.

    Well written!

    Yours in gentle birthings with Hypnobabies,


    Carole Thorpe, CHt, HCHI, HCHD, CLEC, CiHOM
    Hypnobabies® Childbirth Hypnosis, VP
    Director of PR & Marketing
    714.894.2229 (Mon-Fri, 10-4 PST)

    "Thoughts become things...choose good ones!"

  5. This is really wonderful. I am giving birth for the first time in March and I have very little to no fear of pain. Lots of my family thinks I am crazy and even my little cousin, who is only 9, came to Christmas dinner and said aloud, "I sure hope you don't tear"
    I was mortified to hear the fear in her voice and she is only 9! I hope that I can be a voice of "reason" in the American birth culture. Thanks so much for this blog post!

  6. Thank you all so much for your comments! It's great to see such a response to this post. :)

  7. Thank you so much! Wonderful post. Personally, I am loving the hypnobabies training. I love that hypnobabies encourages women to release their fears and also change the way we think about birth. We are about to become first time parents in about one month and I can't wait to share our birth story. I feel confident that it will be a wonderful and joyful experience. I wish every mom could reprogram their thoughts with tools like hypnobabies. But so many first time mom's are overwhelmed with work and changes happening in their lives. There is also a feeling of trust that we want to put into our doctor's hands.... to "deliver" our babies. It can be hard to share this information with mom's, but I think you did an excellent job of addressing anyone who might be sensitive about their past birth experiences. I hope many women read your post.

  8. Thank you, Judi! You have actually touched on the topics of the two posts I am working on next - traumatic birth is one (although I had a wonderful and mostly pain-free birth experience, a series of events that occurred after my son's birth were not ideal, by any means); and authoritative knowledge in birth and pregnancy is the other. I hope you'll continue reading and share with others! Thank you again!

  9. I was awash in the feelings from the the language/experiences of birth as I grew up. The language/experiences and veracity of feeling did not fit my birth experience.
    It could have had I not an extra set of skills. I learned hypnosis as a child while living in and out of the hospital. It came to mind years later when my birthing began so I followed my instinct, used it and woke up refreshed with comfortable baby pushes and no tear, an excellent bottom in fact. I am aligned with the fairly recent paradigm shift in birth.
    Rather than "how bad will it get?", I get to experience, hear and teach, "how great can this be?".
    Thank you Lauren for calling attention to our cultural habitations in birth. Change can be beautiful. I see and feel the change, I am so grateful for it. I adore your writing and Meta-Parenting!

  10. No, I wouldn't believe you. Or maybe I would, because we all have different levels of pain and different ways of perceiving pain.

    However I do not buy that labour pains were created by societal images. It's not like Hollywood sat down one day and said "hmm, let's portray birth as painful - that'll be a hoot!"

    The perception of painful childbirth has its genesis in fact. The fact of painful childbirth for a great number of women across cultures.

  11. @Snorkel, thanks so much for your thoughts. I agree - we all experience pain differently, and I don't dispute that the pain many women feel during childbirth is very, very real.

    I want to clarify that I'm not suggesting there has been a conscious, one-time, conspiratorial "creation" of the image of childbirth as painful and horrible - but rather, that the systematic presentation of it as such (in media, in personal conversations, in doctors offices, etc.) has, over time, helped to perpetuate the expectation that a woman will experience it this way.

    Again, of course I acknowledge that childbirth can be a painful and difficult process, and I would never argue with anyone that their experience was not what they say it was. However, I do think that we can start to examine our views - and those of our culture - in such a way that allows us to rethink the way we talk about birth, and how we prepare women in our culture to experience it. I'm not suggesting that we whitewash reality or gloss over the legitimate pain or emotions of others, but rather that we question the idea of birth as something that should fundamentally and automatically be feared before it ever happens.

    Thank you again for your comments - I really appreciate you chiming in. :)