Distinguishing Truth from Myth and Fears from Reality about Labor Pain

As I was looking for more studies about the drastic increase in birthing mothers who get an epidural for childbirth, I found the following research, published by Stanford medicine, titled:

Study shows women prefer less-intense pain at the cost of a prolonged labor.

Here is what the researchers did: ”For the study, Carvalho and his colleagues gave a seven-item questionnaire to expectant mothers who had arrived at the hospital to have labor induced but were not yet having painful contractions. The questionnaire pitted hypothetical pain level, on a scale of zero to 10, against hours of labor. The women took the survey a second time within 24 hours of giving birth. A sample question asked, “Would you rather have pain intensity at two out of 10 for nine hours or six out of 10 for three hours?” Both pre- and post-labor, women on average preferred less intense pain over a longer duration, according to results published in the British Journal of Anesthesia.”

I find this study to be somewhat disturbing, but revealing at the same time. It is even useful from a coaching perspective. The questions the researchers asked were misleading. Women were asked to weigh their options and choose between coping with labor pain or having a prolonged birth as a potential implication of getting an epidural. But – –  are these the real options they weigh? Is prolonged labor the risk associated with taking an epidural in childbirth, or is it a side effect that might lead to many other potential risks?  I searched “ACOG (American College of Obstetric Gynecology) on the risks associated with prolonged labor”. Guess what came up first in my search results?

Safe Prevention of the Primary Cesarean Delivery

Yep, the risk of Cesarean! Do women really choose between being with labor pain vs. longer painless birth, or between experiencing labor pain vs.  higher potential to have a medically managed birth or a cesarean delivery?

This is exactly the role of prenatal coaching: Distinguishing truth from myth and fears from reality in a world that offers a wealth of online misleading information . A false belief about labor pain and the means to alleviate it was suggested by the researchers. However, the publication of this study and the spread of the false belief it has manifested reveals more than just a careless work of the researchers. It is a reflection of the fear of labor pain and the role of this fear in masking the truths about labor pain and epidural as the most popular mean to avoid it.

How will I coach the client who believes that she chooses between coping with labor pain and a longer but painless birth?

Here are some great coaching questions:

    1. How did you come to the conclusion that you are choosing between these two options: coping with intense labor pain or with long hours of painless birth?
    2. What do you know about labor pain? (you may use the acronym of PAIN to facilitate an understanding of the true nature of labor pain: Purposeful, Anticipated, Intermittent, Normal),
    3. While we both agree that taking an epidural might lead to a prolonged childbirth, and I can see why you wouldn’t mind about these painless long hours, I wonder if you know of any risks associated with prolonged labor?
    4. Would you like us to research these?
    5. Now what seems to be the options you are choosing from?
    6. Is it possible that with professional support, a doula who uses coping skills and provides comfort measures for childbirth, you will not experience intense pain?

With these coaching questions, you will lead your birth client to a self-discovery. She can find answers within herself that are different than those she found online. Those answers are more authentic, and they tend to be more aligned with her true self, with her beliefs and vision for her birth. If you want to learn more on how to conduct coaching conversations around the decision of taking an epidural in childbirth, you might consider listening to our webinar Coaching Your Client through the Dilemma of taking an Epidural” jn  which we shared some of our best coaching strategies around the topic, like the math of labor pain, the wording of it, and the role of curiosity and exploration in coping with it.