# what would cause extreme labor pain at 1 cm?



## meowee (Jul 8, 2004)

This is just a curiosity question, it's not something I've ever been faced with...

Once when in the L&D at the hospital there was a woman next to me in the admitting room who kept saying she was in agony, but she was only 1 cm dilated (I couldn't help but overhear all this). Since then I've read a few birth stories and seen a couple births on TV where the mom says she's in agony at 1 cm. This really puzzles me because my experience has always been that I don't start getting any intense pain until 4-7 cm, and that seems to be the general consensus in a lot of birth stories I read.

I know every labor is different, but is there a particular complication that could cause such severe pain at just 1 cm?


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## MsBlack (Apr 10, 2007)

A malpositioned baby, and/or discoordinate uterine contrax, might cause more pain early than usual.

But you have to realize that 'pain threshold' and 'pain perception' varies quite a lot among women. What was agony for those women might not have seemed bad at all, to you.


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## meowee (Jul 8, 2004)

Yes that's true, but I always hesitate to attribute something to a low pain threshold. I know from experience that some labors just hurt more than others. But agony at 1 cm?


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## gemasita (Jul 1, 2005)

I had a client who also said that she was in agony at 1cm. Then she got an epidural but said she was STILL in agony. They did the ice test on her torso and said that the epidural was working fine. I've always wondered if there was something else going on....


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## SalmonBayDoula (Jul 10, 2005)

Sometimes I think that the cervix needs to catch up with the labor. Mom's cervix may be at a 1, but she is heading to 10 fast and furious. Have had had clients go from 1 to babe in arms in 60 minutes! Yawza!!!

Also, sometimes a woman who is dehydrated can have an early labor that looks like transition, but rehdyrate her (usually with IV, a liter pretty quick) and things calm down pretty fast and look like early labor again!

More of the mysteries of birth!

Sharon


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## Mama2Kayla (Feb 12, 2005)

I was induced with my first and had really bad pain from the begining. They cranked up the pit, and broke my water when I was 1 cm. After that, the pain became very intense over the next hour. It was the worst pain I have ever felt. The nurse kept coming in and turning down the pit. There was no break between the contractions.

Anyway, I learned my lesson with that induction, and stayed out of the hospital with #2. He was born at home after an easy, very manageable 6hr labor







.


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## maxmama (May 5, 2006)

History of cervical surgery, like a LEEP or cryo, is a huge risk factor for pain in "early labor" -- because it's actually the adhesions keeping the cervix at 1cm, and the labor is much more characteristic of 4-5cm.

This is a good indication for therapeutic rest, btw.


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## pookel (May 6, 2006)

Back labor will do it. I had been in labor for 12 hours before I went to the hospital - on their advice, when I could no longer walk or talk through a contraction. They checked me, I was at 0. I walked around the hospital, labored in the tub, etc., all night, and the pain got worse and worse and worse. I remembered Bradley's "signposts" and noticed that I was well into "I can't do this anymore" territory. They checked me again - I was dilated to 1. At that point I'd been fantasizing about shooting myself for a while. I couldn't get the epidural until I was dilated to 4, so I suffered for a few more hours before finally my water broke and I started dilating more. Turned out he was posterior, with a large head, and I pushed for 3 hours with no luck. Ended up with a c-section.

So, in short, yes. It can hurt like you wouldn't believe. It is not always due to a low pain tolerance or unpreparedness or fear or whatever. Sometimes it just hurts a lot.


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## RockStarMom (Sep 11, 2005)

For me, there was no varying pain of contractions. I don't know how dilated I was at the onset of labor, but at the very first contraction I was on the floor, riding out the contractions.


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## MiamiMami (Feb 1, 2005)

I had excruciating back labor with dd. I was on pitocin and had my water broken at 1cm. It was awful- ugly crying, snot dripping, clawing at my dh kind of pain. I never progressed past 1 cm and after just 4 hours on pit was sectioned.
My vbac labor was a piece of cake compared to that. The pain never even came close.


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## Shirada (Jul 29, 2002)

My experience with my first birth was lke Pooel, MINUS the back labor and malpositioning.


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## daileyjoy (Aug 10, 2004)

If a mother was on pitocin at 1cm than yes her contractions are not going to be normal. She is going to be in horrible pain even at 1 cm, that's what pitocin does it makes your contractions 2-3 times worse than that on the woman next door who is laboring naturally.


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## maxmama (May 5, 2006)

Quote:


Originally Posted by *daileyjoy* 
If a mother was on pitocin at 1cm than yes her contractions are not going to be normal. She is going to be in horrible pain even at 1 cm, that's what pitocin does it makes your contractions 2-3 times worse than that on the woman next door who is laboring naturally.

OR...you can be laboring spontaneously and still have a wretched early labor.


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## Lousli (Nov 4, 2003)

I wasn't in agony at 1 cm with either one of mine, but by 3 cm I was in a lot of pain, enough that I was asking for an epidural. Some things that made it worse for me were water breaking before the onset of labor, back labor and posterior baby, extreme exhaustion and illness (vomiting for 3 days, no sleep, pulmonary edema) with my second daughter. For the second one, I'm sure there was also an element of fear since I was so ill and since she was 7 weeks early.


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## georgia (Jan 12, 2003)

My experience sounds similar to pookel's about the pain worsening and my cervix wasn't opening. It was so defeating to me when after hours of hellish contractions to be exactly the same amount of dilation. I was suffering and couldn't believe the pain. I had hours and hours of pitocin-induced labor "stalled" at 1 cm, and I honestly wished I could die







My water had broken, I was flat on my back hooked up to both external and internal monitors, and I was scared.

Quote:

OR...you can be laboring spontaneously and still have a wretched early labor.








Very true!


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## Mama Poot (Jun 12, 2006)

I was in agony for the full 20 hour duration of ds1's labor. The problem was malpositioning, he was posterior and was born that way.







:


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## mommathea (Apr 7, 2008)

Even with malpositioning, and a posterior baby, with all 3 of my babies I never had agonizing labor till I hit transition.
I do know that some women see any kind of labor pain as a nusience and any pain they 'don't need' to have is horrible.


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## naturals (Aug 15, 2007)

during my labor i felt like my butt would burst open, thats how it started and ended too before the c-section and I was only 4 cms dilated.


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## NatureMama3 (Feb 25, 2004)

I get terrible cervical pain the whole time it is dilating, 1cm or 9. same stabbing pain. It's not pretty.


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## fireweed (Nov 27, 2007)

Mine was breech, so another case of malpositioning. After 20 hours of painful, agonizing back labour my water broke with a lot of muconium in in, so I went to the hospital sure that I was nearing transition. I was a fingertip dialated.


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## njbeachgirl (Oct 8, 2006)

I think fear can make perception of pain worse. Just my 2 cents. Maybe mom is unconsciously struggling against the contractions.


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## That Is Nice (Jul 27, 2007)

Back labor.

Been there, done that.

(the baby being incorrectly positioned). It was excrutiating for me at 1 cm. Totally and utterly agonizing. So much so that if I think of it, tears come to my eyes.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *MsBlack* 
A malpositioned baby, and/or discoordinate uterine contrax, might cause more pain early than usual.

But you have to realize that 'pain threshold' and 'pain perception' varies quite a lot among women. What was agony for those women might not have seemed bad at all, to you.

Yes, but a malpositioned baby is going to cause a lot of pain, even if we all feel pain differently.

Having been there myself, I'd venture to say that a malpositioned baby would feel like agony for almost all women.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *pookel* 
Back labor will do it. I had been in labor for 12 hours before I went to the hospital - on their advice, when I could no longer walk or talk through a contraction. They checked me, I was at 0. I walked around the hospital, labored in the tub, etc., all night, and the pain got worse and worse and worse. I remembered Bradley's "signposts" and noticed that I was well into "I can't do this anymore" territory. They checked me again - I was dilated to 1. At that point I'd been fantasizing about shooting myself for a while. I couldn't get the epidural until I was dilated to 4, so I suffered for a few more hours before finally my water broke and I started dilating more. Turned out he was posterior, with a large head, and I pushed for 3 hours with no luck. Ended up with a c-section.

So, in short, yes. It can hurt like you wouldn't believe. It is not always due to a low pain tolerance or unpreparedness or fear or whatever. Sometimes it just hurts a lot.

Thank you. Yes, this is what I had. I get kind of sensitive about people talking about low pain tolerance, etc when it involves back labor and an incorrectly positioned baby.

What I felt at 1 cm was what all the child birth instructors, all my friends, and what the midwife described as the "I can't take it anymore" worst part of labor.

And it lasted and lasted and lasted until I felt like I would pass out. That baby never did come out the intended way...just got utterly stuck despite a midwife, a doula, a doctor, and 3 plus hours of pushing.







:


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *njbeachgirl* 
I think fear can make perception of pain worse. Just my 2 cents. Maybe mom is unconsciously struggling against the contractions.

Not even just the perception worse, but actually worse. Fear inhibits our natural pain-killing endorphins.

I vote fear and/or malpositioned baby.

ETA-Rupture, placental problems, and or cervical tearing could do it too. . .


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *Lousli* 
back labor and posterior baby.









:


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## janiecakes (Jul 4, 2007)

I was in labour for about 17 hours and stayed at 1 cm the whole time because of a big fibroid that prevented the head from descending far enough. It was completely tolerable for the first 6 hours and the rest of it was mind-blowingly painful! Like, contractions every 2 or 3 minutes, barfing all over the place painful.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *janiecakes* 
I was in labour for about 17 hours and stayed at 1 cm the whole time because of a big fibroid that prevented the head from descending far enough. It was completely tolerable for the first 6 hours and the rest of it was mind-blowingly painful! Like, contractions every 2 or 3 minutes, barfing all over the place painful.

I also threw up spontaneously during labor. Is that related to pain? My midwife said that throwing up during labor is not unusual and can happen in all labor, but I never heard anyone else I know talk about throwing up during labor except one other person who also had back labor and wasn't dilating, and also ended up with a c-section.

The throwing up for both of us was prior to any drugs or epidural (we both waited a really long time for that 10 plus hours or so).

Interesting...


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## tex.mom (Jun 30, 2006)

Quote:


Originally Posted by *pookel* 
Back labor will do it.

Absolutely. I tried with my second to get him in optimal position before the onset of labor but he kept going back. I could actually feel him go back when I was lying down at night. So I had back labor and plus labor was only 3 hrs. 45 min., so really fast and heavy with no down time. It hurt from the word go. Though actually, I was already at more than 1 cm leading up to it from the braxton hicks. I've talked to a couple birth professionals who were amazed I let the jets pound my back until it was visibly red in the pics. They've said most women find the jets too intense, at least after brief use. But for me I don't think there would have been such a thing as "too much" pressure on my back.


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## pookel (May 6, 2006)

Quote:


Originally Posted by *Spring Flower* 
I also threw up spontaneously during labor. Is that related to pain? My midwife said that throwing up during labor is not unusual and can happen in all labor, but I never heard anyone else I know talk about throwing up during labor except one other person who also had back labor and wasn't dilating, and also ended up with a c-section.

The throwing up for both of us was prior to any drugs or epidural (we both waited a really long time for that 10 plus hours or so).

That's really interesting - I threw up a lot too. I couldn't understand how anyone would want to eat normally during labor, when i couldn't even keep down crackers.


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## pookel (May 6, 2006)

Quote:


Originally Posted by *njbeachgirl* 
I think fear can make perception of pain worse. Just my 2 cents. Maybe mom is unconsciously struggling against the contractions.

Or maybe the pain is so bad in the first place that it CAUSES the fear.

I really hate this idea that if labor hurts, it's somehow the mom's fault for not having the right attitude about it.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *pookel* 
That's really interesting - I threw up a lot too. I couldn't understand how anyone would want to eat normally during labor, when i couldn't even keep down crackers.

I personally think it has to do with the extreme pain from back labor, but I'm not a midwife or MD.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *tex.mom* 
It hurt from the word go. I've talked to a couple birth professionals who were amazed I let the jets pound my back until it was visibly red in the pics. They've said most women find the jets too intense, at least after brief use. But for me I don't think there would have been such a thing as "too much" pressure on my back.

Yes.







Been there, done that. Sounds very familar.


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *pookel* 
Or maybe the pain is so bad in the first place that it CAUSES the fear.

I really hate this idea that if labor hurts, it's somehow the mom's fault for not having the right attitude about it.

I think the idea is that labor hurts and fear makes it worse. It's not the mom's fault that our culture MAKES women fear birth. If the woman's fear is rooted in ignorance it would be her own fault that she didn't learn more about it.


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## mommathea (Apr 7, 2008)

Quote:


Originally Posted by *Spring Flower* 
I also threw up spontaneously during labor. Is that related to pain? My midwife said that throwing up during labor is not unusual and can happen in all labor, but I never heard anyone else I know talk about throwing up during labor except one other person who also had back labor and wasn't dilating, and also ended up with a c-section.

The throwing up for both of us was prior to any drugs or epidural (we both waited a really long time for that 10 plus hours or so).

Interesting...

My sil threw up the entire labor for all 4 of her kids. For her it is a I believe natural reaction to pain. Even a small injury will cause her to feal nausious..


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *pookel* 

I really hate this idea that if labor hurts, it's somehow the mom's fault for not having the right attitude about it.









:

Yes, me, too.

I really think I had the right idea about labor going into labor. I had a midwife AND a doula. I'd read all the recommended natural child birth books. I took the Birthing from Within Class, and a natural childbirth class. I'd prepared in everyway possible and I still ended up with a malpositioned baby, back labor, then a stuck baby, excrutiating pain from the start despite moving around, stretching, using the birth ball, the birth bar, the tub, the jets, and despite all my best efforts and those of my midwife and doula I still ended up with a c-section.

It just goes to show...sometimes emergency c-sections are warranted. And all the best plans can come undone.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *mommathea* 
My sil threw up the entire labor for all 4 of her kids. For her it is a I believe natural reaction to pain. Even a small injury will cause her to feal nausious..

Interesting. Thanks for sharing. I've been curious about the throwing up connection because when I was throwing up during labor I was taken aback by it.

I never feel nauseated with pain, though, and I don't throw up if I'm in pain. Just happened during very intense back labor. So strange.


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## NatureMama3 (Feb 25, 2004)

I dunno, I really disagree that it is only fear that makes it more painful. Not everyone's physiology is the same. Some of us really do have severe pain from what causes no pain for others. No fear, just pain.


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## allgirls (Apr 16, 2004)

Throwing up...I did it 3 out of 4 times and twice I threw up after delivery(natural deliveries) so it wan't pain for me, it's just something that happened









I know I watched a show about a pregnant former heroine addict who was in excruciating pain at 1cm...the documentary narrator said former drug addicts have a notoriously low pain tolerance..it just messes with that whole thing.

My friend who had back labour had serious pain at 1-2 cm..excruciating. With the first. With the second, no back labour she had a breezy l&d so I think back labour is a likely culprit.


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## SMR (Dec 21, 2004)

I was in agony for days - every 3-6 minutes and got to the hospital to find out that I was only at 1!! How horrible that feels to be going through such pain and NOT even be progressing! My whole labor until the cesarean was this way.. I think I have a pretty high pain tolerence too... I'm hoping that the baby i'm carrying now comes out a little more comfortably!


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *NatureMama3* 
I dunno, I really disagree that it is only fear that makes it more painful. Not everyone's physiology is the same. Some of us really do have severe pain from what causes no pain for others. No fear, just pain.

That is true.


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## DocsNemesis (Dec 10, 2005)

Pit is evil. Oh yes.

Also, anyone who has sudden, strong contractions early on would be in a lot more pain, as the body is designed to release more endorphins as the pain increases. When you suddenly have a huge amount of pain, the body cant compensate. So even though the contraction might be just as strong in you as her, you've had the chance to work up to it and your brain helps reduce the stress/pain in the process. She hasnt.

Id also imagine if the mom was VERY tense and scared, the pain would be insanely worse. In that case, an epidural might be the right thing to do, as the pain relief would help them to relax. Although if it were say, a fear of hosptials or something, I dunno if itd make a difference.


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## NatureMama3 (Feb 25, 2004)

Quote:

anyone who has sudden, strong contractions early on would be in a lot more pain, as the body is designed to release more endorphins as the pain increases. When you suddenly have a huge amount of pain, the body cant compensate. So even though the contraction might be just as strong in you as her, you've had the chance to work up to it and your brain helps reduce the stress/pain in the process. She hasnt.
yes, that!! my labors do not progress in a "typical" pattern. they start out intense and stay there.


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *NatureMama3* 
yes, that!! my labors do not progress in a "typical" pattern. they start out intense and stay there.









:

My contractions from back labor were intense. One on top of the other and quite long and strong even at 1 cm. It never let up. It sucked. Sucked big time.


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## Romana (Mar 3, 2006)

I haven't posted on MDC for awhile but I can't let this one go without adding my 2c.

I have had two excruciating births, 21 and 18 hours, respectively. First time, labored at home for 19 hours before going to the hospital, arrived ready to push. Last 8 hours of labor were unbearable.

Second time (planned home waterbirth), I think the baby was slightly malpositioned - like asynclitic head or something. May have been the problem the first time, too - I have scoliosis and my spine is a bit wonky down there. I had chiro adjustments during the last tri but they can only do so much. Anyway, "very painful" started after only a few hours of contractions, and "excruciating" started 8 hours before ds was born. Although I wasn't checked by my midwife, I believe I wasn't dilated at all until 2 hours or less before ds was born.

I was not afraid either time, not for a moment. Fear had nothing to do with it. It was just totally and completely 100% excruciating, give me a gun and I'll end it now pain. I'm tired of being told by well-meaning people that I should try a birth tub/warm water for the pain (BTDT, laughable), that it's because I'm subconsciously afraid or anxious, that I must have a low pain tolerance (opposite is true), or that a natural birth won't/doesn't/can't hurt that badly. Sometimes, for some women, birth is just excruciating and there's very little, if anything, that they can do about it. Except maybe get an epidural (which I have not done).

I hate that sometimes people assume that it "can't" be what the woman says it is because of some objective criteria that is heavily relied upon. I trust her; I think she knows better than anyone what her pain level is. I wish HCPs were more willing to listen (though some are great; I had a great midwife with #2).


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *Romana9+2* 

I was not afraid either time, not for a moment. Fear had nothing to do with it. It was just totally and completely 100% excruciating, give me a gun and I'll end it now pain. I'm tired of being told by well-meaning people that I should try a birth tub/warm water for the pain (BTDT, laughable), that it's because I'm subconsciously afraid or anxious, that I must have a low pain tolerance (opposite is true), or that a natural birth won't/doesn't/can't hurt that badly. Sometimes, for some women, birth is just excruciating and there's very little, if anything, that they can do about it. Except maybe get an epidural (which I have not done).

I hate that sometimes people assume that it "can't" be what the woman says it is because of some objective criteria that is heavily relied upon. I trust her; I think she knows better than anyone what her pain level is. I wish HCPs were more willing to listen (though some are great; I had a great midwife with #2).

Well said!
















:


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## That Is Nice (Jul 27, 2007)

Quote:


Originally Posted by *Romana9+2* 

I hate that sometimes people assume that it "can't" be what the woman says it is because of some objective criteria that is heavily relied upon. I trust her; I think she knows better than anyone what her pain level is. I wish HCPs were more willing to listen (though some are great; I had a great midwife with #2).

Right on.










I'm not being overly dramatic that when I say after experiencing my excrutiating and seemingly never-ending back labor that resulted in a very stuck baby and an emergency c-section, that I understood how so many women used to die in labor.

I know medicine has made advances (most good, some excessive) since the pre-1920s, birth has itself become too medicalized in many instances, but, darn it, sometimes c-sections and epidurals are medically necessary. And this is coming from a natural childbirth, midwife supporting, doula loving MDC member.









That said, most births can be beautiful and natural.


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## pookel (May 6, 2006)

Quote:


Originally Posted by *Romana9+2* 
I was not afraid either time, not for a moment. Fear had nothing to do with it. It was just totally and completely 100% excruciating, give me a gun and I'll end it now pain. I'm tired of being told by well-meaning people that I should try a birth tub/warm water for the pain (BTDT, laughable), that it's because I'm subconsciously afraid or anxious, that I must have a low pain tolerance (opposite is true), or that a natural birth won't/doesn't/can't hurt that badly. Sometimes, for some women, birth is just excruciating and there's very little, if anything, that they can do about it. Except maybe get an epidural (which I have not done).

Hey, I always seem to meet you on these threads.







:

I wanted to add that I DID get an epidural, which worked wonderfully, but when it was turned down to half-strength for the pushing phase, the pain got worse again - worse even than before I got the epidural. So it might not have been an improvement for you anyway.


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