Pain is a primary symptom driving women to seek analgesic relief during labor and the lessening of pain commonly defines a successful result, regardless of its potential to have an adverse effect on the birth process.
During labor a physiological stress response may be evoked not only by pain but also by fear, perceived threats to safety, status, or well being and these are all sensations that trigger the fight, flight or freeze response.
There exists an abundance of evidence that links chronic stress and pain, these studies suggest that exaggerated psychological responses such as fear, catastrophizing, and negative coping are “maladaptive” and likely to intensify the pain experience and impede the birth process.
This is all rather fascinating but beyond the scope of this article, rest assured it will have its own article. For now, just accept that an “adaptive” response to Acute Stress (FFF) such as movement is the appropriate choice.
There are two alternative responses to the experience of labor induced pain sensations:
- the avoidance, catastrophizing response that may prolong labor, prolong pain, and augment a cycle of suffering, pain, anxiety, stress and fear. (Mal-adaptive)
- the confrontation response- you meet labor head on, developing meaningful effective strategies to manage contractions and break the pain-fear-avoidance cycle. (Adaptive)
Fear is an emotional response that can freeze you up or get you moving.
When a stressor continues after the initial Acute Stress response it builds into repeated surges of hormones that left unchecked builds into a sense of anxiety, fear, and distress and chronic stress.
When the initial surge rushes in demanding you to do something, to go, to take action—answer the call with powerful focused movements.
Such as the constant steady movement of your legs and/or arms during a contraction as this will do wonders to work off the build up of excess stress hormones in your body.
The mastery of your labor pain involves you finding and utilizing various Yoga-Based Birth Skills to work off the stress that surfaces in your body as the eustress of contractions build up over time.
If you panic and freeze during your contractions then you will feel more pain, more tension, a decreased release of endorphins and oxytocin—all of which results in a slower less efficient labor.
This choice of response, if left unchecked, leaves you feeling that it is enormously difficult to maintain any command or control over your labor. You slip into the Avoidance Response (A) and you become overwhelmed and unable to cope.
If adrenaline had the ability to vocalize its needs it would shout: Get up and move!!
So instead shift into powerful action, and moving is a simple way to turn away from suffering and back towards coping and managing. Confrontation Response (B)
What you can sense you can change. Be a careful listener and learn to recognize these signs. When you are in tune with the needs of Birth then:
- you will instinctively move to a new position that brings more ease
- you will speak up to get what your body needs
- you will drink when thirsty
- you will eat when hungry
- you will give voice to your experience.
SUTRA II.16 HEYAM DUHKHAM ANAGATAM
Suffering that has yet to manifest is to be avoided.
In other words— pain that can be anticipated can be avoided.
Yoga is about working through discomfort to find ease and comfort. It will never mean deliberately keeping the body in sustained uncomfortable contorted or painful positions. I hold true that posture should be steady and comfortable and that is how I teach asana.
The Whole Way method is about learning to work with your body—finding both ease and strength. It is counterintuitive to remain in positions during labor that have no value, that are not evidence based—positions that hinder rather enhance progress in labor.
Asana is about applying movement to the body to quiet the mind, to give mastery and control so that it fixes the mind on the task at hand-the labor of birth.
All women have the potential to experience unbelievable pain in labor but we also have the potential to produce behaviors and actions to reduce it.
You will have no direct control over contractions or the level of pain, so don’t waste time trying to control what you can’t, instead put 120% of your energy into what you can control.
You absolutely have control over what to do with:
- your legs and arms
- your hands and feet
- your breath and sound
- your eyes and ears
- your nose and skin
- your thoughts and words
As previously said, pain is your body’s signal to move. There is no specific recipe or special time—just use what works best for you
Mild pain requires mild adjustments —moderate pain moderate adjustments—big pain big adjustments.
More intensity=more stress=more adrenaline=more potential energy=more pain reducing potential
Match the level of action to the level of sensation. More sensation—then move faster, stomp harder, vocalizing instead of just breathing.
Research shows that the level of to which women can master their labor pain is based on the level of pain and their ability to adapt to pain. What ever technique you use— pain mastery comes from your level of pain adaptability.
Pain is not always a reliable sign of what is actually happening in your body. It is instead “volatile complex sensation that is completely tuned by the brain and is often over-protectively exaggerated so much so that the sensitization often becomes more serious and chronic than the original problem.” Paul Ingraham; Pain is Weird; online article
There is no such thing as a “pain nerve” as nerves do not detect pain—nerves detect some kind of stimulus in the tissue and the brain decides what to make of it, how to feel about it and what to do about it..if anything.
People seldom if ever realize how powerfully pain is influenced by perception. Pain in fact is nothing more than “opinion”— it is an interpreted experience that is surprisingly sensitive to context.
These “all in your head” implications are all very fascinating so rest assured that there will be articles regarding the “pain phenomena”.
Is it likely that you will be able to think labor pain completely away—probably not—but it is within your power to influence labor pain sensation if you understand it.
You can adapt your responses to labor eustress so that you can directly lower your feeling and awareness of that level of pain.
Contraction pain involves exposing yourself to short manageable bursts of eustress that increase as labor progresses. Unless you continue to adapt along the way the eustress (contractions) will become unmanageable.
Your brain builds memories surrounding your response to each and every moment of an Acute Stress Response—if you build adaptive memories then you will cope well the experience of labor and if you build maladaptive memories then you will begin to feel more pain, stress and anxiety and fear and you will be less able to cope with your labor experience.
In the context of labor, adapting well means adding activity to these 60 second intervals of eustress. Your response can be passive, active, mental, physical or a mix of all of the above.
During a challenging workout your are using your muscles in a healthy way. Is it pain-free? Nope, in fact it is the painful contraction of the muscle you are working that strengthens the muscle.
During the challenge of Labor you are using your uterine muscles in a healthy way. Is it pain-free? Nope, in fact it is the painful uterine contractions in labor that do the work.
Healthy activity creates healthy workable forms of eustress. During labor, uterine contractions represent a healthy workable form of eustress and the utilization of movement as a pain-free means of distraction is an example of how this concept works.
Using your legs is one way to adapt easily to the stress of labor and take control of your contraction pain. Leg activity changes your perception of pain by stimulating sensations at other sensory reception sites—soles of your feet, skin of your legs, hips, ankles, knees, etc. These sensations which are pain-free sensations are then transferred to the brain. If you generate enough leg activity your brain will register this as the dominate sensation rather than the uterine contraction.
Your PAIN-FREE leg activity will take precedence over the PAIN-FULL uterine contraction.
The same logic holds true for whatever part of the body you decide to move and why that burn didn’t hurt until you sat down to your turkey dinner.
The brain can only focus on one thing at a time and it will always focus on the dominate sensation. Essentially you will work to override the painful sensations by bombarding the brain with PAIN-FREE sensations.
Unless there is a STRONG medical reason, every woman has the right to choose what she does and remaining in bed is one of her options, if bed is NOT where you want to be—no problem. MOVE! Laboring women can stand, sit, lie down, kneel, lean, walk or use any other position that suits.
Aside from the physical benefits that come from using movement during labor, it is also a valuable tool for expression.
Stomping, clapping, yelling— we’ve all expressed ourselves in this manner—at a Steelers game, at a concert, while dancing. Hopping mad, dance it out, SHOUT!
Use Movement as a means of expression, not just for joy or exuberance but as an outward expression of pain during labor. Use movement as a means of turning fear and pain into positive actions. These are very helpful ways to harness acute stress signals and turn them into positive actions that help labor to progress.
Use Movement as: an expression of pain — a distraction—a means to mobilize endorphins—as a primary and secondary tool—pair it with counting, visualization, in the shower, bath, bed and/or on a birthing ball.
During the FFF response your large muscle groups (the largest being your legs) undergo instant surges of energy during times of need so that they may be recruited immediately to adapt to the crisis. (1/2 way up the tree)
This means that we have been given the physiological means to use our legs to help us cope with pain, danger, and stress and not lose control.
If this Adrenal complex is not literally moved out of the body it stays and becomes chronic. Using movement as a birth skill keeps it moving right along by quickly and adaptively metabolizing it away.
Save leg work for later, when you can literally no longer remain still during a contraction, rest and use low level distractive activities during early labor. This is the adaptive response as it allows oxytocin preceptors to proliferate and keeps stress hormones at a minimum.
Match the level of movement to the level of pain. Pace yourself. Ensure that you are upright, you are using gravity to its best advantage. Movement is only pain-free until you exhaust yourself.
Mobilize yourself with a rhythmic pain free activity (rhythms and rituals are of great comfort during labor) a focus that helps put fear and panic on the back burner.
If you do something and you focus on it, you will have decreased your conscious ability to register fear and panic, and you will have definitely decreased your brain’s perception of pain.
During a contraction, your uterus produces stress, which triggers the adrenaline pump that fuels the action you need to take in order to cope.
GO is the greatest thing your partner can say if you are having trouble getting out of a shock/freeze state. Don’t persist with relax when go is needed.
Take an immediate action—not too big or too small but just the right amount to swiftly counteract the perception of pain.
Labor is not easy -you just get better at it—this holds true no matter what you are working on. If you know what to do, you have competence and control over the task at hand. This allows you to put hesitation and inhibition on the back burner and into the flow of the experience.
In the context of Labor this means that for each 60 seconds duration of a contraction you instantly apply the resources required to see you through.
The more you focus on pain free skills the less you will feel fear—remember your brain can only focus on one thing at a time. You will get into the zone—in the flow. You will suspend thoughts, mind stuff, fear, inhibitions, panic and hesitation.
You must focus and I mean focus on the activity for this strategy to work well. Use whatever you need— when passive rest during contractions begins to bring about suffering, move on, instead give yourself layers of distraction.
I have geared my Prenatal Yoga Classes so that they are almost entirely constructed of Birth Skills, simple doable actions that can be done as-is— or easily modified into more usable skills—as a stand alone skill—or as a skill that mixes well with others.
Using MOVEMENT as a birth skill (indeed all of the skills found in the Whole Way) are well supported by evidence from science, anthropology, psychology, and medicine.
