Tuesday, April 10, 2007

Understanding Pain

After having five children, four of whom were natural, unmedicated births, I felt I had a fairly respectable pain threshold. I could breathe and tone my way through first stage labour, and with some amount of effort, would finally pop out a wrinkly, pink baby to show for my day's work. It was an ordinary miracle, and one that I had a fairly good idea of how it would unfold, barring some rare emergency.

So it was with quite some dismay that I found myself in a large tangled heap on our local ski mountain, hollering away like I'd just severed a limb.

I had just started my second run down of the morning, but a combination of icy conditions and a lack of experience culminated in me propelling myself down the hill at speeds that were uncharacteristically fast (though the tears streaming out of my eyes from my break-neck speed seemed to blur any real sense of my pace). In the milli-second I had to figure out how to remedy this situation, I decided it was best if I simply bailed on this ski run by heading toward the rough snow, off the beaten path, until I could bring myself to a stop. When the crunching and mashing sounds ended, I felt an exquisitely sharp pain in my right knee and instantly knew I was going to die. If not death, my leg was likely completely broken in many spots and I should just continue punching the snow with my free fist while screaming unintelligible sounds. Nausea overcame me soon and I had to pause from this no doubt helpful verbal exercise so as to try to avoid the stomach activity that can often accompany nauseous feelings. My husband and a ski patrol person (whom I'd just previously sailed by while waving jovially) joined me by now and they were able to help me calm down, breathe slower, and relax my troubled soul.

In the end, neither my knee or my leg were broken. And I did not die. I tore some of the meniscus around my knee that likely won't need surgery, just a lot of physiotherapy, exercises, rest, ice, and a bit more time to heal up. But why did I react to that pain in such an unfamiliar way? Where did my pain threshold disappear to?

I think the answer lies in the fact that when I'm bringing about a new life into this world, it's neither a medical emergency or an unexpected event. Instead, it's something I am preparing for, welcoming, and even excited about. I have a fairly good understanding about the process that is going on inside of me, and I understand the pain. But in the example of my knee injury, the event was all that childbirth wasn't... the injury was a medical emergency; it was unexpected; it was not something I had prepared for, wanted, or considered exciting. I had no idea what was going on inside of me and I did not understand the pain. It just kept reminding me that something was wrong and I was in trouble.

The common denominator here is that both of these events contained pain, but the big difference was my attitude. I had no fear in the birthing process, so that decreased my anxiety, which increased my pain coping skills and allowed the endorphins to course through my veins and fill me with my own natural morphine. But the ski injury event was full of fear. I had no idea what I had just done to my body and the damage I had possibly caused. I didn't know how I was going to get off the ski hill to some help. I felt every sensation ten times more because I was trying to access how wrong things had gone inside me. My stress hormones were overwhelming any endorphins that were trying to provide comfort, and my fight or flight response was on full alert.

And so my goal as a doula and childbirth educator, is to help women remove the fear that can often surround childbirth, and instead, replace it with understanding. Understanding of how their body is amazing and that it knows what to do without us needing to do anything. Understanding that the sensations of birth aren't signals of something going 'wrong', but of so much going right. Understanding that women are powerful and surrendering, loud and quiet, soft and strong.

- Heather McCue

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