Changing the way society thinks and talks about birth could improve women's experiences of labour pain, according to La Trobe University research.
Labour pain expert Dr Laura Whitburn conducted interviews with new mums in Melbourne to try to understand why women have such differing experiences of labour pain.
"Labour pain is very different to other pains because it arises during a natural process in which a woman's body is doing what it should be doing, rather than by something going wrong," said Dr Whitburn, a physiotherapist who teaches anatomy in La Trobe's School of Life Sciences and has just published the latest in a series of findings resulting from interviews with women at Mercy Hospital for Women, and Sunshine Hospital.
"There's no denying labour contractions are extremely intense. The pain is very good at capturing the labouring woman's attention, and motivating her to seek safety and care during birth. But my research shows that not everybody experiences this pain in the same way".
Dr Whitburn found that women who were able to think of labour pain as "purposeful pain", and were able to remain "present" and "focused" during labour had more positive experiences.
Women who did not make a link between the pain and its role in labour were more likely to feel distressed or overwhelmed by the pain, or to use medical interventions.
"Women who labour with the mindset that there is a purpose to their pain appear able to make pain part of the experience. They are less likely to need interventions such as an epidural or C-section," Dr Whitburn said.
"The messages women receive about labour pain before labour, and the way they are supported during labour, can influence how they perceive the pain and their capacity to cope with it.
"It seems that one key element to remaining focused and resilient during labour is who is caring for you - having a midwife or support person who you know and trust, and who is sending positive messages about your body and your progress can boost a woman's sense of ability to cope with the pain," she said.
She emphasised there is a clear distinction between 'normal' labour pain associated with the physiological process of normal labour, and 'abnormal' pain, associated with a complication which may require medical intervention, regardless of a woman's mindset. However, medical experts are concerned about rising rates of unnecessary medical interventions that can increase health risks to mothers and their babies and Dr Whitburn hopes her research will help to re-frame the discussion around pain and empower women.
"Unfortunately, the way labour is portrayed and communicated can suggest to women that they are not capable of coping. Instead of supporting women to work with their bodies during labour, our current birth culture undermines them. By re-framing the way we think and talk about that pain, we may be able to reduce medical interventions and improve women's experiences," she said.
Australia has one of the highest C-section rates in the world, and is more than double that recommended by the World Health Organisation. In 2017, 78 per cent of women giving birth in Australia used pain killing medication and 35 per cent of women had a C-section up from 31 percent in 2007.
Selection of responses from women who told Dr Whitburn about their labour pain:
- "I remember thinking 'this hurts, but it also feels awesome!'"
- "As soon as I found out I'd need a caesarean section it felt more painful because I knew that it wasn't working towards giving birth"
- "...you had it in your mind the whole time that the contractions were good even though they were painful it was good because it was sort of tracking your progression."
- "They assessed me and told me that I would need a forceps delivery so they were going to give me an epidural…So then I thought, 'Oh well, the epidural is going to take care of the pain and the contractions now so I can stop focussing. It's going to be easy now'. And as soon as I lost my focus I started getting pain. I became more focussed on the room and the people around me. I was focusing on all the outside stuff instead of focussing on what was going on inside me. I had more of a normal everyday mind."
- "It didn't feel like a sick pain, it felt like a productive pain"
