Before I dive into the meat of this post… I want you to think out the following scenario in your mind. It’s 3:00 a.m. and you are awakened by the sudden urge to pee (one of the many perks of pregnancy). In your sleep drunken stupor, you ram your toe at full speed into the door frame on your trip to the bathroom. A sudden lightning bolt of pain shoots from your toe to your brain… but what happens next? I can guess it probably involves jumping, screaming, yelling, and maybe even a tear or two. I can also guess that you also probably instinctively grab your toe – both to verify its existence after such a collision, and to rub it for comfort. Everything in the typical reaction makes sense… except for the toe rubbing. Have you ever wondered what makes you want to do that? The answer may surprise you.
Ok, I have one last example I want you to consider. Have you ever been around a toddler? Despite their best efforts to maintain proper balance when tearing around the house, they are ALWAYS falling over. It’s true that they are more “rubbery” than adults because their bones are still largely cartilage, but their resiliency to pain is quite remarkable. Is this because they have a higher pain tolerance than we do? Or do they know a secret to pain? The answer is both.
Pain is something you probably experience every day and is crucial to your well-being. One of the most important processes related to pain during pregnancy is called the pain trap. It looks like this:
Pain --> Bracing --> Constricting --> Worsening of Pain --> Helplessness and Freeze Response
In this post, I will illustrate a few techniques to stop this pain trap cycle.
There are millions of specialized pain fibers spanning nearly every centimeter of your body – constantly updating your brain on the status of the external and internal environment. Your brain – being the amazing organ that it is, is tasked to receive this information, assess its importance, and act accordingly. Pain is an input (like thought) that we decide to act on or ignore. For example… if you start to get a stomach ache from eating 2 Costco hot dogs, your brain receives the pain information, and you decide to hold off on drinking your fruit smoothie. In that same example, a competitive eater may start feeling the same pain after 2 Costco hot dogs and suppress the urge to stop so they can pound down 10 more hot dogs AND a fruit smoothie. The pain felt in both examples is the same, but what is DIFFERENT is the interpretation and reaction. This is the basis of phrases like, “Beauty is Pain”, and “No Pain, No Gain”. Athletes and competitors choose to overcome the pain input to push themselves. When ballerinas balance on pointe, they don’t have decreased pain signals to their brain… but greater control over how they interpret that pain.
As you can see, the basis of pain signaling in the body is a bottom-up process – from the pain receptors in your extremities to the pain interpretation in your brain. Lets now talk about how this pain signaling is balanced and regulated by 5 top-down processes.
- Gate-Control. Lets flashback to the first scenario we talked about of stubbing your toe. Why do we rub it? The answer is quite incredible. As you rub your toe, the touch receptors in your skin fire off signals to your brainstem. Before relaying this touch sensation to your brain, they actually BLOCK the pain signal pathway from that same area! In essence, by rubbing your toe… you are actually making it hurt less! This is some of the basis for pain interventions like light touch, massage, and transcutaneous electrical nerve stimulation (TENS) therapy. This is called “Gate-control” because the touch sensory pathway acts as a gate to keep pain in check. This is why we talk about light touch in our mindful childbirth course.
- Mind over Matter. You’ve probably heard of the placebo effect, right? Two people are given pain medication after wisdom teeth removal and one of the pills is just a sugar pill? Well, it turns out that our brain has the ability to create hormones that work in the SAME way that powerful pain medications do. These natural pain medications (opioids) are called enkephalins. They act on nerve fibers running down from the brain to stop pain transmission from reaching the spinal cord. Many women and physicians are hesitant to use opioids in childbirth because of the adverse effects to both mom and baby, which is why it is KEY to activate this system during childbirth (more on this later). These effects are discussed more fully in the childbirth education course and in the mindful childbirth courses.
- Distraction. Think back to the second example I talked about in the beginning of this post with children and their resiliency to pain. Their resiliency doesn’t come from a lack of pain stimulus, but rather from an incredible ability to ignore it. If you play sports you know that injuries during a game are often MUCH worse once the game is over. This is because our ability to “Tough it out” means diverting our attention from the pain to something else. This is also the basis of why many parents try to distract their toddlers after taking a fall. This is also the neurophysiological basis for our mindful childbirth course – using natural methods of relaxation and meditation to help manage the perception of pain. Our state of mind helps us choose how to interpret and react to pain.
- Perspective-Taking. I can sum up this pathway using a phrase from earlier… “No Pain, No Gain”. You probably use this method the most. For weightlifters, it’s “pushing” through to get that last set when your entire body hurts. Some suggest that this is what gives the “runners high” to push through the physical strain of long distance races. This pathway is similar to the mind over matter, and likely uses the same pathway. For mothers, the experience of childbirth is a “tug-of-war” of many perspectives. When contractions begin, many focus on the fear and pain they are immediately feeling. They anxiously anticipate the next contraction and find themselves in a state of panic. Once the baby is out, the pain seems to flee as the excitement and joy of a new baby become the prominent perspective. Using mindful childbirth techniques, we can focus on contractions as important steps to welcoming this new baby into the world. We can think of labor as an active interaction between mom and baby to allow one of the greatest miracles we will ever experience in life.
- Relationships. Having your loved one/support person there for you doing the difficult stages of labor will do wonders. For my childbirth experiences, I was blessed to have my mom and husband there for support. Both were on board with the mindful childbirth strategies I had been practicing, so they were able to help me get through the crucial moments where I was second guessing myself. My husband joked after our first that he would remember to take off his wedding ring before giving my hand for support during contractions 😉
Pain is a natural response our body has established to maintain a safe environment. During childbirth, however, only you can choose how to interpret this pain. If you haven’t prepared, it may take you by surprise. It’s my hope that you will use the techniques listed above and achieve the childbirth experience that YOU want for yourself and baby. Remember this quote…
“Pain is inevitable, but suffering is optional.”