Can I Have A Pain-Free Birth?

Years of social conditioning - from the stories our mothers have told us, to the vision of birth we see portrayed on television and in films - has taught us that that phrase, “pain-free birth” is not just an oxymoron but a complete fallacy. And yet women - not all women by any means, but a significant number of women - report no pain in their labour. So what does this mean? Are they mistaken? Lying? Superhuman? Is it a question of mindset and perception of pain? Or is there a way to choose a path to a pain-free birth?

The first question is, how common is pain-free birth? Rebecca Dekker and the Evidence Based Birth team scrutinised several studies from the 1990s that suggested that around 1% of respondents reported experiencing no pain in labour. While these studies were small and by no means conclusive, it’s fair to say that the number of women who would describe their labour in this way is small. Even if this difference is anecdotal rather than scientific, there must be something behind it - so do these women have a physical difference from those who find labour painful or even very painful? Or is the difference more likely to be psychological?

Anyone who has practised hypnobirthing, or even anyone who is familiar with its principles, knows how important the language used in the birth space is. Hypnobirthing practitioners advise the use of gentler terminology - surge instead of contraction; down breathing rather than pushing - and this includes using more positive words to describe labour “pain”: pressure, sensations and tightening. Hypnobirthing families also often decline any discussion of pain levels or discomfort to allow them to focus their minds on the positive and natural process of birth. They are encouraged to embrace each surge as positive pressure that brings their baby closer to them - in the same way that a marathon runner or bodybuilder embraces the impact of their exertions as bringing them nearer to their goal.

This switch in mindset - to think of labour as hard but natural physical exertion rather than the kind of pain caused by injury or illness - is credited by many as the key ingredient to turning birth from something to be feared to an event to be celebrated and even enjoyed.

One of the forefathers of the 20th century renaissance of natural childbirth, Dr Grantly Dick-Read, was born in 1890 - at a time when many doctors and obstetricians believed that they had to intervene in birth in order to facilitate a baby’s safe arrival. Dick-Read’s practice with both socially disadvantaged and very affluent women led him to believe that his primary role was to allow women to birth as their bodies were intended to. He conceived a concept known as the “fear-tension-pain cycle” to explain what he saw as the discrepancy between the fear that affluent and educated women had about birth, and the pain that they experienced in birth as a result. He noted that women living in poorer areas, who had no fear of birth and who believed that they would birth straightforwardly, seemingly experienced little or no pain.

The shift in mindset to view birth as positive, and the removal of fear to avoid tension, both contribute to the theory behind a pain-free birth - but in addition to those mental shifts, there are also some changes to your immediate surroundings that can help facilitate the absence of pain. 

“Your social environment, including your care providers, family, and hospital staff can greatly influence your pain perception,” Rebecca Dekker of Evidence Based Birth explains. “In other words, the social interactions you have during labour can affect your state of mind, which then affects your thoughts and emotions, which then leads to influencing how you interpret your pain. Social interactions might leave you interpreting your pain as manageable and productive, or unmanageable, scary, and threatening. This means that the words and actions of individuals who interact with laboring people have the power to influence how they perceive their pain.”

There may be several factors that contribute to pain-free birth, none of which we fully understand, but a positive mindset, the absence of fear, and a relaxing environment are all a great start.