Last week I spent several hours in the dentist’s chair having some major (to me) dental work. I thought, “I take back everything I’ve ever said to myself about using drugs to address fears.” For women who are as scared of birth as I am of the dentist, I completely understand their desire for as much pain medication as is available. My fear of the dentist is irrational. I have never had a bad experience. My dentist does a wonderful job of numbing any area that he works on. Yet when he offered nitrous oxide in addition to the local anesthetic, I eagerly accepted the unnecessary analgesia.
I am the first one to bristle when someone compares natural childbirth to dental work without anesthesia. Drilling into a tooth is not a normal, physiological process. I am a big proponent of the purpose of pain during labor. I know that pain cues a woman to seek a safe place for birth with supportive companions. Many times I have seen laboring women move into positions that aid labor progress as they respond naturally to the pain they are feeling. But if a woman is almost paralyzed by her fear of childbirth (as I am of the dentist), then she will most likely not get to the point in labor where she is responding to her pain with position changes, rhythmic movements, and rituals. She may not even get to a childbirth class. Instead, she will have scheduled her cesarean or chosen epidural analgesia (and bedrest) very early in labor. Just as I could benefit from some desensitization counseling about the dentist, we, as a society, need to do a better job of addressing the fear of pain in childbirth. Years ago, researchers compared the attitudes and birth outcomes of women in the Netherlands with women in the United States. The Dutch women expected labor to be hard work, but they anticipated that they would be able to cope without pain medication and they did. The American women expected labor to be so painful that they would need pain medication in order to cope. And they did.
Sitting in the dental chair, I vowed to think about better ways of addressing fears about birth. We all need to raise our children with positive stories of pregnancy, birth, and breastfeeding; to volunteer in schools to talk about birth; to share with our friends and acquaintances our joy in birth; and to provide opportunities and time in our childbirth classes for frank discussions. We need to help women identify and face their fears and to develop tools and confidence to deal with the challenges of labor. Wouldn’t it be wonderful if our culture were more like the Dutch culture in which women know that they have the strength and power to give birth?