Distinguishing Pain from Suffering
My labour with my first child was about 17 hours from start to finish. This was from the moment I felt the first twinge–the first tightening of muscles in my belly–to the moment she arrived into the world. It wasn’t intense and dramatic that entire time. It built slowly, giving my body and mind a chance to slowly adjust to the changes that were happening.
After about eight hours of labouring at home, we headed into the hospital. I was assessed and moved to a birth unit room and my body continued its process. I had decided to not have any pain medication. I was in pain, but I was coping okay. I felt supported by my partner and I felt confident in my body. I also really trusted my medical care team (including a nurse, a midwife, and Obstetric Gynacologist Doctors nearby if I needed them). In short, I felt calm.
But, after a few hours, I started to feel as though I could not cope. My baby had turned, such that she was “sunny side up” facing the front of my body. The optimal position for the baby during birth is the opposite- baby is facing backward toward the back, (“over easy” if you will!) Because of her positioning, the back of her head was pushing against my sacrum (tailbone). The back pain was intense. I was also having something called “coupling” where you do not get space between contractions. Unknown to me (until after she was born and the nurse explained it to me), my uterine muscles were working double time, pushing my baby down, while at the same time, trying to turn my baby too.
I had never been told that this was a possibility. I had been led to believe in all my prenatal classes, and all my midwife appointments, that I would get spaces between my contractions to pause, to breathe, to build energy for the next one. As a result, I felt confused, overwhelmed, and worried. I was inwardly panicking, and unable to ask for reassurance because I couldn’t talk during contractions, and I was having no break between them. I therefore remember clearly the moment during my first labour when pain crossed over to suffering. I distinguish between these two things in the following way:
Physically experiencing pain during labour is inevitable (when unmedicated). Your body is using muscles in a way it will never use muscles at any other time in your life. I love using the acronym PAINE to help people understand how pain during labour is different than other experiences of pain:
P- Purposeful - there is a reason for it, and an end goal
A- Anticipated - we know beforehand we are going to experience it
I- Intermittent - it’s not constant, it comes and goes with contractions
N- Normal - it’s typical to experience pain during labour
E- Ends - we know before long it is going to end
Suffering is different. Suffering is when we mentally feel we cannot cope with the pain. Suffering is a mental response to a physical phenomenon.
I believe it’s possible to feel pain without suffering. And the reason I believe this is because with my son’s birth four years later (13 hours from start to finish, home birth, unmedicated) I didn’t suffer. During my second labour, pain didn’t cross over into suffering, because I better knew what to expect. I felt more prepared, and I felt I knew more going into it. I felt the whole way through the labour process that I knew what my body was doing, each step of the way.
This is why I feel so strongly about educating families during pregnancy to prepare deeply for labour. Above and beyond that, I am an extra set of eyes in the delivery room to ensure you are supported. If I see something arise. which I know you are not prepared to expect, I'm there to help.I can explain things in real time so you know what is happening and you don’t have to feel confused, worried or overwhelmed. You (and your partner) don’t have to wait until after the birth to understand what happened, you can both be informed during the process.
As a doula, I can help you experience and cope with the inevitable pain, without crossing over into suffering.
