"Jennifer Tow, IBCLC" <[log in to unmask]> wrote:    I have come to the conclusion that pain is a cultural construct. In the 
US in particular we are taught that pain is to be avoided at all cost 
and we attach the concept of pain to anything that is not comfortable. 
Think about what women are taught about childbirth--how to cope with 
pain. Everything focuses on coping with pain--if this is the case, then 
the given is that there will be pain. We are not taught the power of 
birth nor even the possibility that birth can be painless, even 
ecstatic. We are only taught fear, yet we all know that fear induces 
pain. The same is true of breastfeeding--how many women are afraid of the pain of breastfeeding?
  I see this too.  But I have decided to wage my own war on this whole concept.  I'm a CNM who is currently working in a school of nursing because I can't arrange a collaborative arrangement that would allow me to practice midwifery in my community.  So I have a captive audience of around 100 nursing students each year.  I am approaching them with the idea that as nurses we learn that pain always has a meaning, pain warns of cancer, pain warns of other injury and leads one to seek help.  
   
  So I ask my students' what is the meaning of the pain associated with childbirth?
   
  Then I lead them to think through the reasons a mother would need to have pain--seek a safe haven for birth, seek assistance with birthing process from trusted attendants.
   
  Next I ask them to think about the meaning of a woman's pain during childbirth to other people, those who are with her.
   
  Then I help them to think through the protective instincts that are activated by seeing someone in pain.  And how the focus is on the woman and this most important event in her life.  I recount to them the study done by Penny Simkin in which women were able to recall the details of their natural birth stories as clearly 20 years after ther birth as they had 6 weeks after.
   
  And I ask them to observe the atmosphere of irreverence and jockularity that is often seen in the presence of the epidural, or the woman and her family sleeping through this important event.  I ask them to think about the nature of the memories that are being created and those that are being lost by this management of birth.
   
  Then we talk about how having others support and nurture the mother decreases the need for all the interventions that they are seeing in our hospital with its 25-27% c-section rate and the approx 75% epidural rate.  I have them go with the IBCLC's who are working with the babies who don't latch and have all these difficulties related to the meds and hope that here and there they will see the baby who gets it right from the start.
   
  And I always make sure they see a wonderful gentle birth on video with the baby going right to the breast soon after birth, alert and aware of all those present.
   
  We mustn't dispair.  We have to fight this cultural war at all opportunities or we will lose the cumulative knowledge of these things and then where will our grandchildren learn the value of these things.
   
  "Peace on earth begins with birth." the slogan used by National Association of Childbearing Centers needs to be ringing out loud and clear all over this land.
   
  off my soap box now.  I'm really our of breath.
  Melinda Hoskins, MS, RN, CNM, IBCLC

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