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I often begin with an exercise called "Scaling Pain." I want to find out what parents believe about labor pain. I ask the class, "On a scale of 0 to 100, with zero being a painless birth and 100 being the most intense pain you can possible imagine, rate the expected intensity of your labor pain.

A year after taking our classes, Colleen, a first-time mother, pensively recalled what she learned during this process:

When you asked us to rate what we thought labor pain would be, I thought to myself, "It couldn't be as high as 90 or 100, or it would have been written about. Amazing Births I've read wouldn't have glossed over that part - so it must be an 80. "I waited to hear what other women would say first. The first said "50," others offered 60 and 90. Another suggested "80." I was trying to get the answer 'right'....

You responded, seriously, "You're not even close - near the end of labor, at the peak of the contractions, the pain will reach 100 ... 110 ... even 120." At first I thought, "Don't tell us that! You're scaring us! We're fragile and need to be told it's not that bad....

But I knew you were telling the truth. It just made sense! I was already motivated to birth without drugs but at that moment I understood I had to get ready in order to do that.

After that confronting introduction, I had Colleen's attention -- I had everyone's attention -- and curiosity. Now we were ready to begin practicing the pain-coping techniques.

WHY DO I PROVOKE WOMEN TO WORRY ABOUT LABOR PAIN? Because I know women who worry "the right amount" do the best in labor.

Why? Because worrying activates searching for resources, both inner and outer. Worrying also motivates mothers to practice pain-coping techniques while there's still time to master them. On the other hand women who are over-confident about handling labor pain and don't prepare for it, are in for a surprise.

I've identified five beliefs and attitudes that keep women (and their partners) from worrying the "right amount:"

1. "Labor is not that painful if a woman relaxes and has the right attitude."

2. "I want to be open minded. I'll try to do it without drugs, but if it gets too difficult, I'll get something to take the edge off, or get an epidural."

3. "There's no reason to suffer childbirth pain nowadays" (often linked to the rationale, "You wouldn't have a tooth pulled without anesthesia, would you?").

4. "My doctor said I could have an epidural as soon as I'm admitted to the hospital - so I don't have to worry about pain."

5. "The new drugs and epidurals are 'perfectly safe' and do not affect the baby."

About a third of each BFW class is devoted to developing a pain-coping mindset. Our goals are to expand mothers' pain-coping tolerance and confidence, teach our unique pain-coping techniques, and reveal the fallacies in the five beliefs and expectations listed above.

We also talk about the physiological role that pain plays in normal birth. Nature's blueprint for birth includes pain, and this pain is purposeful. The sensations women experience in labor are part of an ingenious feedback mechanism which is essential to normal labor and birth. The painful sensation of the cervix stretching open sends messages to the brain to release more oxytocin, the hormone that causes strong contractions of the uterus - which causes further opening of the cervix.

Labor pain also guides the mother. The positions and activities she feels more comfortable with are the same ones that promote good progress in labor and help shift the baby into the right position for birth. Removing labor pain wipes out that feedback mechanism. Mothers with epidurals wind up on their backs hooked up to machines, restricting their ability to move freely and use gravity to help get their baby out.

If you are interested in learning more about developing the pain-coping mindset and skills needed to birth through the pain of normal labor, read the 65 page section called "Birthing Through Pain" in our book, BIRTHING FROM WITHIN: An Extra-Ordinary Guide to Childbirth Preparation.

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