A pain that pays

One day in the early years of the 20th century, a young doctor attended a birth in the East End of London. The mother was a young girl having her first child. Believing she needed pain relief, the young doctor offered her some drugs. The girl refused; once the birth was over and the baby safely delivered, the doctor asked her why. "It didn't hurt", she replied. "It wasn't meant to, was it, doctor?"

I was reminded of that story when I read of a new study from Sydney that has found mothers are more willing to put up with pain in childbirth than are many clinicians. They, it seems, believe the discomfort women go through is sometimes too high a price to pay for a natural birth; women, on the other hand, accept that there's no gain without pain. And some, like the young girl in the East End, don't actually register what's happening to them as pain anyway – even though onlookers take a different view.

The name of the girl in my story goes unrecorded, but the doctor concerned was Grantly Dick-Read, and he went on to make it his lifetime's work to help women find childbirth an easier and more fulfilling experience. For Dick-Read, the lesson learned in the East End was that childbirth is more than what a doctor sees and what a doctor registers: it's also about an emotional experience, even a lifetime rite of passage, and there are – for many women – other factors involved than pain (even, sometimes, quite strong pain).

Could it be that it's not so much that women can't stand the pain of childbirth, but that often it's all too much for those in attendance – especially the medical staff? The entire medical system is based on being able to ease pain and suffering (one of the many reasons it would be a good idea to question the role of hospitals as the "normal" place of birth, in fact). The natural response of a medic (especially a doctor, as opposed to an experienced midwife) is to want to alleviate pain; but in childbirth, there's every reason to believe that pain is different from the pain of disease. It's often referred to as "pain with a purpose"; labouring women certainly register it as pain at the time, it's true (I remember thinking, as I pushed one of my babies out, that this was just too much – I'd never be able to go through it again, even though I knew I wanted more babies).

But women are aware that, all too often in childbirth, alleviating pain comes at a price. Drugs that take the edge off contractions may reduce the efficiency of contractions and reduce the urge to push; the result may be a forceps or even a caesarean delivery. How much easier to put up with an hour or two of pain and walk away from a delivery without having gone through major surgery or an assisted delivery. And how amazing nature is at helping wipe out the memory of the pain. As I looked down at my new daughter after the labour I've just described, I laughed with my husband at the idea that I'd thought I could never go through this again. I did, of course, twice more – and the thought of the pain to come didn't enter my mind for a moment as I went through my pregnancies.