Wednesday, November 08, 2006

More made up medicine

One of the most serious problems with the claims of natural childbirth advocates is that many do not know about the mechanisms of labor pain. Instead, they have made up their own theories of labor pain which have no basis in reality. If your understanding of labor pain is grossly incorrect, how can your claims about the nature of the pain, who feels it, and how to manage it be taken seriously?

A Google search on "why is childbirth painful" illuminates the problem. Consider these made up explanations of labor pain:

From Birthing Naturally.net: "Quite simply, your uterus is a muscle. Instead of running a race, it contracts rhythmically to open the cervix and push the baby out. But the same principles that can cause pain in running, can cause pain in laboring.

If you are laboring with tensed muscles, you will use energy faster, causing you to feel tired more quickly than if your muscles were relaxed.

Tensing your muscles can also hinder the efficiency of the uterus. During a contraction, your uterus will tighten and move forward. If your abdominal muscles are tensed, this will cause restriction of the uterus, and you will feel the pressure of the muscles working against each other. If your back muscles are tensed, the ligaments that connect the uterus to the back will tug on a muscle that does not want to move. Once again you will feel the pain of the muscles working against each other."

From Childbirth.org: "Your muscles are working, and this may cause pain which can be reduced by relaxation. Holding your breath and fighting contractions can actually hinder dilatation and labor, and be more painful by depriving your uterus of oxygen and creating tension."

From the Expectant Mother's Guide: "Simply put, the pain of childbirth comes mostly from fear which (based on the horror stories of others) physiologically causes the body to work against what it wants to do to birth a baby."

Yes, the uterus is a muscle, but it is not a voluntary muscle like the ones you use when running. It is an involuntary muscle just like the heart or the muscle fibers that move food through your intestines. It is no more under your control than chest pain, or the pain of an intestinal blockage.

Furthermore, there are not two sets of muscles working against each other. The pain of labor, just like the pain of a heart attack or the pain of intestinal blockage cannot be eliminated by reducing "fear". There is no evidence that "tension" is involved, and holding your breath is not likely to increase labor pain, because the major component is not oxygen deprivation of the uterine muscle.

The pain of contractions is a type of visceral pain; viscera is the technical name for the internal organs. The uterus reacts similarly to other internal organs. When they are stretched, they produce pain. Visceral pain in other organs is not treated by relaxation, reducing tension or reducing fear. While these measures may modulate the experience of the pain, they do not affect the pain itself.

It is pretty clear that these made up explanations were created after the fact, to support the socially constructed notion that pain in childbirth is not "natural" or is easily amenable to simple measures that any person can take. Such a complete misunderstanding of the nature of labor pain renders suspect any claims of natural childbirth advocates about how much pain there should be, and what can be done to relieve it.

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