laboring in waterAs a culture we believe that pain is unacceptable. But when we numb out sensation in labor, we diminish our endorphin levels and the endorphin levels of our babies. The pain is dulled, but so is the exuberance we are meant to experience afterwards, when contractions are over and mother and baby bathe in the highest endorphin levels, higher than what marathoners get. Martha Beck captures it when she wrote, “Anyone who has felt the pain of bearing a child, or pushed past physical limits in some athletic event, or struggled to learn difficult but powerful truths understands that suffering can be an integral part of the most profound joy. In fact, once suffering has ended, having experienced it seems to magnify the capacity... to feel pleasure and delight.”

Because endorphins are released in spurts during labor in the brains of the mother and baby along with oxytocin, when the endorphin levels are tampered with due to the use of pain medication, oxytocin is also reduced. Oxytocin drives labor, and when levels drop, labor slows. That is part of why 50% of women with epidurals require augmentation with Pitocin, which is synthetic oxytocin. Pitocin risks include fetal distress, uterine rupture, cesarean birth, postpartum depression.

Sometimes when a mother has great difficulty relaxing, or is exhausted, an epidural is a blessing. The problem is not the use of epidurals, it’s the overuse. Women with excellent preparation and appropriate support are less likely to find themselves in situations where they need epidurals. Taking an independent childbirth class to learn and practice comfort measures and support techniques, including use of the birth ball, massage, rebozo, hot/cold therapy, counter pressure, ahead of time is invaluable. The more tools the mom has, the better equipped for labor she’ll be. Place of birth matters. Laboring with access to a tub and unlimited food and drink helps. Choosing a professional team that includes a doctor, midwife and/or nurse who regularly support unmedicated women, means laboring with people who know what to do. A doula can also make a big difference; her only job is to provide physical, emotional, and informational support. “Birthing women can never have too much support,” Carol Densmore told me in an interview. “If people seek good support it’s not a sign of weakness or vulnerability. Rather, being well supported and well held, allows childbearing women to access their deepest courage.”

Midwives throughout human history have developed strategies and tools to help laboring women. “The choice is not between anesthesia and unremitting agony.” Sandra Steingraber wrote. “One is not asked to lie in a hospital bed and... bite a bullet and suffer.” Pain in childbirth, unlike most pain, is not a sign that something is wrong. The mom who is in a place mentally where she can understand that and work with, rather than against, her contractions, will experience labor quite differently. And when it is over, when she’s done it, and she’s holding her newborn, she’ll likely have a sense of satisfaction and of her own strength, a great platform from which to begin the work of new motherhood.