Goshen News, Goshen, IN

November 11, 2012

WHOLE FAMILY: Going ‘natural’ doesn’t equal masochism


— Whatever goonies keep track of my Internet searches are likely to have a colorful read this week. I looked up, for the purpose of writing this column, the term “masochism.” Masochism means, in its most commonly used definition, deriving pleasure from pain. But in many definitions, a sexual component is mentioned or implied — as in people enjoy receiving pain during a sexual encounter.

Thus the risqué search results.

For my own commentary on this column topic — the pain of childbirth, particularly — I don’t plan to further mention masochism in a sexual context. But just to be edgy, here’s your sex reference: There’s pain in childbirth, and you get childbirth after you’ve had sex.

YOU MIGHT THINK being a proponent of “normal, natural” — normal, natural living in general, but normal, natural childbirth specifically — is sweet and easy. It’s not.

When it comes to birthing, if you use the terms “normal, natural” with many people, they’re likely to label you a crunchy crackpot or worse — label you a masochist, maybe. Bizarre, I know, but it’s true. Remember, we live in a nation where 99 percent of women birth in a hospital room “just in case” something goes wrong and where during at least one in three births something does “goes wrong” enough that surgery is deemed necessary.

More telling about how U.S. women view birthing, I think, are statistics about the use of pain medication, specifically epidural anesthesia, in labor and delivery. The Centers for Disease Control and Prevention reported that in 2008, 61 percent of U.S. women having a first-time vaginal birth received epidural or spinal anesthesia (http://www.cdc.gov/nchs/data/nvsr/nvsr59/nvsr59_05.pdf).

(By default, those women birthed in a hospital, not at home or birth centers, where epidural anesthesia is not used. No, no pain meds — and definitely no epidurals — at home or birth center.)

Of course 61 percent is an average, so you have institutions where 80 percent is the norm and some where 40 percent is. I once attended a birth in a nearby hospital where I noticed, while on a hallway search for coffee, that there was an epidural tray parked outside of most every labor room — just crouching and waiting, it seemed, for the patient to cave.


In short, most U.S. women are terrified of birthing. They’re definitely terrified of the pain, which they’ve been conditioned to believe — by media, by other women and by medical care providers who enjoy copious salaries and hero statuses directly because of women’s fear of childbirth — is heinous, torturous and every other awful “ous” you can imagine.

SO, WHEN SOMEONE calls you a “natural birth Nazi” or worse, he or she might say, “You’re just a masochist. Not me. I don’t like the pain.” It’s a strange argument, usually undergirded by one’s own insecurity, to suggest that people like me — normal, natural proponents — are masochists.

Ask my own birth attendants and they’ll tell you: Steph did not like the pain. In fact, she used some colorful terminology toward it, words we didn’t know she knew.

Here’s the BUT, though, the point: Most childbirth pain is normal, natural. Because it is so, it really is — usually — manageable. In fact, at the risk of being called a masochist, normal, natural childbirth pain is  good.

I’ve been preparing a talk for fellow nursing students, a talk I dub loosely, “Natural Childbirth.” In preparing what to say, this struck me:

Most health-care workers, nurses especially, are taught two things about pain: One, pain is pathology; and two, pain must be stopped, usually via medication.

It’s likely at least the former is true for most situations: Pain is, commonly, evidence of something wrong. Could be outright trauma, nerve troubles (“neuropathy”), some sort musculoskeletal misalignment. Even a simple deficit like malnutrition or low blood sugar can cause pain. Whichever woe causes the pain, it usually is that — a woe.

But check this out. Childbirth is not a woe, not usually. Childbirth pain is not pathological. It is supposed to be there. It’s normal, natural, yes, but not all that common in a life span of 80 years to push 7 pounds of baby through a tiny space that has to contract and stretch in great proportions.

So it hurts. Childbirth hurts. And it’s OK.

A pain assessment is considered, these days, to be a vital sign finding, as in we students nurses are taught to always ask our patients, “Are you in pain?” And if the answer is yes? We’re taught — most times — to check for what medications we might be able to administer.

“Alternative” methods to pain relief — say, dimming the lights or reducing sound or relaxation exercises — sometimes get a nod from health-care workers, but that’s usually because it’s just too soon to give another Tylenol.

Because I’m early in my nursing career, I don’t yet know yet about patients with chronic — or even acute — pain. I’ve read just a little and realize pain management is an holistic and worthwhile discipline in and of itself. To those who suffer from chronic pain: You have my sympathies — perhaps my care one day — and not my criticism of  how you handle it. I’m counting on you to educate me.

But I do know about childbirth pain, both having felt it and witnessed much of it in others, and I can tell you we would do well to leave it in a category of its own and not treat it the same way we treat trauma pain or chronic pain.

So next week I’ll go a little further and write about how to manage childbirth pain without Pharmacia. You might be surprised how simple — normal, natural — it is.

Goshen News columnist Stephanie Price is a wife, mother, teacher, childbirth educator, midwife’s assistant and nursing student from Elkhart. Contact her at wholefamily@goshennews.com, 269-641-7249 or on Facebook at the page “Whole Family Column by Steph Price.”