A study recently published in the March 2009 issue of BJOG: An International Journal of Obstetrics and Gynaecology has found that for about half of women who give birth, memories of the intensity of labor pain decline over time, for some women, their recollection of pain does not seem to diminish, and for a minority of women, their memory of pain increases with time.
I could not access the original study online but I did find an article published by Reuters Health Stories that summarizes the study.
As a labor & delivery nurse, I have heard many a time a mom in the throws of her second, third, or forth labor yell out, “I don’t remember it hurting this much last time!!” It doesn’t matter if “last time” was 18 months ago or 18 years ago, anecdotally I personally have found that women do tend to “forget” the pain of childbirth. It is interesting that this study did find that for about 50% of women, this is true.
But what I found most interesting about this study were the following two things:
#1) The study found that a woman’s labor experience (positive vs. negative) was an influential factor. The study found that women who reported labor as a positive experience 2 months after childbirth had the lowest pain scores, and their memory of the intensity of pain had declined by 1 year and 5 years after giving birth. However, the memory of labor pain did not decline during the observation period for women with a negative overall experience of childbirth.
#2) The researchers found that women who had epidural analgesia remembered pain as more intense than women who did not have an epidural, suggestive of these women remembering “peak pain.”
Reading this article reminded me of the book Birthing From Within by Pam England, CNM, MA. In her book, England writes a lot about a woman’s prior labor/birth experience and how much it can affect her future pregnancies and labor/birth experiences…especially the negative ones. She writes about how important it is for a woman’s birth preparation and prenatal care to not just include learning about tests and birth technologies, but to include talking and exploring a woman’s hopes, secret fears, unresolved grief, self-doubts, and visions of birth. England’s “Birthing From Within” classes use birth art as one way to achieve these objectives.
Regarding epidurals (and again, anecdotally speaking) there have been many times in my practice as a labor & delivery nurse that an epidural doesn’t provide the mother with the relief she was seeking. The epidural could be one sided, there could be a “window” of pain, or it could provide no relief at all. It had always seemed to me that if the epidural never worked or more so if it worked for only a while and then wore off, that the women seemed to have less ability to cope with the pain for a variety of reasons. In an article for Mothering Magazine entitled Epidurals: risks and concerns for mother and baby author Dr. Sarah J. Buckley MD writes:
“Beta-endorphin is the stress hormone that builds up in a natural labor to help the laboring woman to transcend pain. Beta-endorphin is also associated with the altered state of consciousness that is normal in labor. Being “on another planet,” as some describe it, helps the mother-to-be to work instinctively with her body and her baby, often using movement and sounds. Epidurals reduce the laboring woman’s release of beta-endorphin.
Obstetric care providers have assumed that control of pain is the foremost concern of laboring women, and that effective pain relief will ensure a positive birth experience. In fact, there is evidence that the opposite may be true. Several studies have shown that women who use no labor medication are the most satisfied with their birth experience at the time, at six weeks, and at one year after the birth. In a UK survey of 1,000 women, those who had used epidurals reported the highest levels of pain relief but the lowest levels of satisfaction with the birth, probably because of the higher rates of intervention.”
Certainly some food for thought…