My obstetrician was explaining the mechanics of birth. Effacement. Dilation. Transition. His words danced past my ears without sinking in, as surreal and new as the sound of my baby's heartbeat had been moments before. My husband interrupted. "But what does labor feel like? I heard it's like trying to pass a grapefruit through your, um, rectum." The doctor smiled. "More like a watermelon, actually."
Eight months ripe, I stared at them in horror from my perch on the exam table, two men for whom the discussion was purely, shall we say, speculative. Then I pressed my legs together. Tightly.
Like many women, I was scared witless of labor -- that is, until I went through it (three times now). Then I discovered that although it hurt like hell, I loved giving birth.
I got a rush from the no-turning-back-now certainty of my water breaking. I marveled at the raw power of muscles I'd never known I had. I felt like the center of the universe. When life finally popped out from between my legs, slippery red-blue and as startling as a glimpse of a shooting star, I was plumb awestruck to realize that the previous nine months of mystery and wonder really did end in a baby.
Later, lying in my hospital bed surrounded by flowers, the memory of a long, sharp contraction flashed across my consciousness like a phantom limb. "I can't believe I did that," I thought. That's when a whole new set of feelings kicked in: Amazement, that a nonjock like me had aced a grueling marathon. Pride, that I'd required no medication that might have endangered my baby. And a sense of kinship, corny yet cosmic, with every woman who had ever given birth.
Of course, loving labor does not mean having a pain-free delivery. Or a drug-free one, for that matter. You might have a hospital cesarean or a home birth, push just twice or endure a 24-hour saga. The particulars vary, but there are certain common denominators that seem to strongly shape a woman's attitude toward her birth experience, experts say. And sure enough, I found that they made all the difference in mine.
I Expected Pain But Wasn't Intimidated By It
"Most first-time moms don't have a clue how much labor will hurt," says Robin DiMatteo, head of the psychology department at the University of California at Riverside. Women often shield pregnant friends from the sorry truth, she says. Or a fearful expectant mother may belong to the "I'll just ask them to knock me out" school, shielding herself from scary information. However, lack of knowledge about pain is precisely what ends up terrifying women most, says DiMatteo. "They're suddenly surprised by the intensity of the pain and convinced it means something's wrong, which makes them more anxious, which leads to an increased perception of pain. It's a vicious cycle."
That's why familiarity often breeds contentment for second-time mothers. "I was less frightened and a lot more fascinated by what my body was doing," recalls Darlene Rachlow of Fort Wayne, Indiana, the mother of 1- and 3-year-old boys.
We're also the victims (or beneficiaries) of our cultural expectations. Mothers' and sisters' stories, ethnic traditions, and general trends all shape our attitudes about what labor "should" be like. In a study comparing women's expectations of labor pain in the United States and Holland, for instance, American women were much more likely to anticipate a need for medication -- and, indeed, ended up being more likely to receive it.
The bottom line: Labor hurts -- maybe worse than anything else you'll ever experience in your life. But by girding yourself for this reality and coming to terms with what you expect and why, you'll be in the most receptive frame of mind to confront that pain.
I Was Equipped to Deal With the Pain
As silly as I felt talking about focal points and cleansing breaths with ten other waddling women in my childbirth class, the information helped me understand what I would experience. But not all pain-management instruction is alike, warns Mae Shoemaker, president of the International Childbirth Education Association in Minneapolis. Credentials are less important, she believes, than the teacher's experience, teaching style, and general approach to labor and delivery. "Think about what kind of birth experience you want. Interview several instructors, just as you would a new doctor or a contractor," Shoemaker suggests. One red flag: teachers who soft-pedal. If they refer to labor pain as "discomfort," run.
Which method is best? That depends on the amount of control you want and your philosophy about birth. But don't be afraid to incorporate your own personal pain-management strategies. I depended mightily on music -- 12 hours of the Grateful Dead for my son and 10 1/2 hours of Neil Young for my daughter.
I Felt in Control Yet was Open-Minded
When my obstetrician asked if I had any particular expectations about my delivery, I took the opportunity to unload my fears of needles, drugs, and being confined to a bed. When I went into labor (and there were no complications), he arranged for me to have no IV and no restrictions on my movement.
This lack of unnecessary medical intervention made me feel more in charge. Researcher DiMatteo found that two types of control were important to feeling more fulfilled by childbirth: self-control (the kind you get through pain-management techniques) and situational control (having a degree of autonomy about everything from your body positions to whether you get to wear your glasses to watch the birth).
Some current obstetric trends are providing women with more control, too. These include homey labor-delivery-recovery rooms and birthing centers, the resurgence of midwives and doulas (women experienced in labor and delivery who provide support, but no medical aid), and certain medical practices, such as allowing women to follow their natural urges to push.
As helpful as choice and control are, they come with a caveat: A woman must be flexible enough to alter her plans as conditions demand. After all, giving birth is nothing if not unpredictable.
I Had Terrific Support
In recent years, the burden of support has fallen on fathers-to-be, but neither you nor your partner should feel bad if he isn't the best candidate for coach, stresses Penny Simkin, a Seattle childbirth educator. "It's not everyone's shtick to provide the constant, capable, upbeat support a laboring woman needs," she says.
Some women turn to a friend, their own mother, or a doula. As for myself, I had terrific support from my husband, as well as my labor nurse, who stayed an hour past the end of her shift to help.
I felt comfortable and confident. And, strange as it sounds, I kept thinking about pregnant women in war-torn Bosnia and in Jane Austen's England. Women have always given birth, I figured, and with far less knowledge and professional expertise than I was privy to. I knew I wouldn't die and reasoned that wherever my body took me, the journey wouldn't last forever.
Certainly, good preparation and support created the right conditions for such thoughts. But I also credit something less documented in the medical literature: faith in myself. When it comes right down to it, labor is a bit like attempting to scale a mountain or write a novel. Before you start, the task seems monumental. But something inside you trusts that you can do it, so you take a step, write a word -- or power through your first contraction. And after that, you start to believe in your ability to keep going.
No, you can't guarantee a perfect, easy delivery any more than you can request a boy or a girl. But it is possible to go into the experience with optimism, and perhaps to come out of it feeling that way, too. It just takes a little advance planning and a willingness to surrender to the miraculous normalcy of the event. Try it. You might like it.
Paula Spencer is a mother of three in Knoxville, TN, and a contributing editor of Parenting magazine.