In a message dated 1/10/1 7:45:53 PM, [log in to unmask] writes:

<<  I agree with Judy that the pains women endure with menstruation help

prepare for labor. >>

I wonder if this perception is one more example of that which is common
perceived as normal. It is not necessarily normal to "endure menstrual pain".
The only time I ever experienced pain or even severe cramps was when I had
endometriosis. I personally believe diet plays an an enormous role in this
kind of pain. Although that leads to the possibility that the poor health of
many women in Western cultures (poor diets, little excercise, high stress,
overworked) may have the same impact on labor pain.

<< I also think the cramps after delivery were worse than contractions,
especially with #s 2,4,5 >>

I have seen this definately impact bf success in mothers who are attempting
to bf a subsequent baby after AF a previous baby.

<< I think it's just as important that we don't sugar-coat or philosophize
the fact that labor hurts. >>

IMO, birthing is misrepresented in most childbirth classes or birthing
methods I am familiar with. I think part of the reason is that we do not
really have the terminology to describe it to women who have never given
birth, any more than we are able to describe bf to a pregnant woman who has
yet to bf. In even using the word pain, we are using a word that elicits
memories of very different experiences from one person to another. I find a
similar problem in using the word "sore" to describe nipple pain.
    OTOH, I think there is also intention on the part of many educators to
minimize fear by misrepresenting the potential for pain. I think this often
works in reverse in that women begin to feel intense contractions and fear
what will come, since this is not what they expected.
    I am trained as a childbirth educator, but over the years have come to
believe that childbirth education is part of the problem, not the solution.
Childbirth education evolved at a time when fathers began to be present at
births. It seems to me that the method of dispensing information does 2
things. First, it speaks more to the way men learn that the way women learn.
Secondly, it "educates" women intectually, but we must get out of our heads
to give birth, not get into them.
    As with bf, it is my experience that the best education for birth
prepares women to create an internal climate which will allow them to
perservere in both birth and breastfeeding. I do believe we birth as we live
and so addressing who we are as women (and couples) prepares us best. It is
the same as my intention in educating my children--if they know how to live
in the world, and how to learn, they can accomplish anything. But, if I try
to teach them specific things I think they will need to know, I limit their
ability to succeed to those realms. I really do think birth and bf depend on
the intangible aspects of ourselves far more than on those we can easily
grasp.

 <<Nonetheless, women deserve to know what we know after we

have given birth.  It hurts. >>

Sometimes. And sometimes it doesn't. I don't think we realize enough how much
these perceptions are culturally based.

Jan writes:
<<It would be interesting to explore exactly what type of pain women were
having that believe their labor pain was the most excruciating pain ever --
was it unrelenting back labor? Was the baby in a funny position?  Was it
Pitocin induced?>>

I think this is important. Just as real, unbearable pain in bf indicates real
problems, so does this kind of pain in birth.  Having done hospital labor
support, my experience was that pain women felt they could not cope with
could easily be avoided, so long as interventions were avoided and signs of
potential problems were quickly tended to (ie--get a mom with back labor into
knee-chest position--do not break her water!!!).  Even better, try to support
her in following her own intuitions--many childbirth classes teach women to
follow an external guide. There is nothing more powerful about giving birth
than becoming aware of our own intuition. As Rachel (I think) said, in normal
birth, real unrelenting pain becomes a barometer for assessing real problems.
But pain viewed through the lens of the epidural as the norm gives no useful
information at all.

<<What is it that makes women of today believe they MUST have something to
assuage the pain -- that they can't get through it contraction by contraction
(and yes, this DOES relate to breastfeeding -- big time!)>>

You are so right--it is the same belief that makes them willing to give up bf
the minute there is any difficulty. AF assuages the "pain" of breastfeeding.

<<.  Is it fear of the pain?  Are we not teaching moms how to cope with it
correctly -- is "blocking" the pain, a la Lamaze techniques -- what we need
to be teaching, or is helping the mother sort of get inside her contractions,
visualising what is going on, concentrating on her body and her deep,
relaxing breathing the best way to go?>>

Trust. There is nothing more powerful in birth than trust in the process.
Trust allows us to be in the moment, to handle things as we go along. Fear
keeps us in the future, dreading a moment unlikely to ever come, unless we
create it with our fear. IMO, there is no "method" that can do this.

<<I've had excruciating, unrelenting pain -- two adult earaches at separate
times, both in the right ear, in which I was kneeling on the floor, pounding
my head against Bob's knee in overwhelming agony.  I'd birth 10 babies before
I'd willingly submit myself to that sort of pain again.....>>

Yep, I would rather birth those same 10 babies than have another kidney stone
or endometriosis again!

<<What can we do to help these women not need epidurals/pain medication for
normal labors?  But how can we convince them prior to labor & birth that they
need to work with the labor and experience the ineffable joy that comes after
successfully running the marathon that is labor?>>

Well, that is the $64,000 question, isn't it? I think the same answer will
tell us how to cultivate in women a real committment to breastfeeding, rather
than a mild interest in "giving it a try". I'm sure I am not the only one who
has noticed the terminology women use re: birth and bf--"I'm going to try to
go natural" or "I'm going to try bf". I know I have said this repeatedly, but
I do believe we succeed at what we commit to and a woman who "tries" bf will
succeed at having "tried" bf, just as a woman who is going to "try to go
natural" will usually succeed at "trying" to avoid interventions.

I used to ask women if they had a natural birth and knew when they said
"yes", it meant with no drugs at all. Now, if I ask a woman if she had an
"unmedicated" birth, she usually excludes an epidural or pit from her
definition of medicated. I actually have to then ask specifically if she had
an induction or an epidural. Women actually consider an induced birth w/ an
epidural "natural" As long as the baby came out of the vagina, it is natural!
Is it any wonder the same mothers think it is just as good to pump and feed
EBM in bottles (the new rage around here--lasts about a week and a half). Or
that giving AIM supplementally is no big deal or that "doing both" is like
getting the best of both worlds.

Karen wrote:
<< Too many women (in the US, anyway) seem to think that natural childbirth
is an insurmountable goal, and thank God for anesthesiologists! >>

Yes, and thanking God for the AIM at the same time. After all, normal birth
and breastfeeding are just ideals, not something real people can actually do.

<<But here's where I think this relates to breastfeeding: When a baby is born

with too many interventions (a healthy baby, of course...), mom is left

thinking (on some level) that her body didn't or couldn't do what it was

"supposed" to do, (or that she couldn't handle it) so how can we expect her

to have confidence that her body will do what it's "supposed" to while

breastfeeding? >>

What is also so diminished in the medicalized birth is also the experience of
the baby. There is so little attention paid in birth today to the active role
the baby plays in a physiologically normal birth. When birth is normal, the
mother is usually aware of this, as she and the baby respond to one another
in the process of birthing/being born. I think there is more trust if the
mother perceives the baby as capable of acting, of eliciting appropriate
responses, of having a relationship with her.

I have a friend who says "assisted birth means assisted bf".

Jennifer Tow, IBCLC, CT, USA

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