Childbirth: Is Pain Inevitable?

What is the point of having (so) bad during this moment of happiness shared by most mothers? Beyond the body signal, pain could have a communicative virtue. It would be a question of seeking comfort and help when the start of work begins, in order to be surrounded at birth and to optimize its survival, as well as that of your baby.

But is pain still useful in the 21st century? For the medical profession, no. And for 50 years, techniques to alleviate pain (as well as lower mortality) have improved considerably.

Why is human childbirth considered painful?

“Compared to other primates, human childbirth is difficult due to the large size of the fetus compared to the maternal pelvic channel,” summarizes the 2016 report proposed by researchers in the journal Pnas. This is called the obstetric dilemma, due to the development of human intelligence and walking.

Bipedia imposes a narrow basin, when the brain (brain) increase in babies would assume that the mother's basin widens. Result ? The size of the baby's head is just passing (at the cost of various rotations), sometimes causing A widening of the basin Upon passing or a light (and provisional) deformation of the baby's skull. Although the obstetric dilemma Or mainly admitted, certain studies (for example that of July Bouhallier of 2006) still question it, specifying that other factors that bone walls are more decisive as to the outcome of childbirth. For Evolutionary researchersthe arguments that go against the obstetric dilemma remain false and ideologues (2023 study).

Anyway, in this tight and complex choreography, pain generally accompanies work. If we want to be precise on their sources, they are divided into three phases, according to this memory of the Sauvagnac Océane midwife:

• Phase 1: The pains come from the contractions that dilate the cervix and stretch its lower part.
• Phase 2: In complete dilation, pain intensifies with the stretching of the structures of the small basin.
• Phase 3: During the expulsion, the pain reaches its maximum because of the stretching of the perineum and the genital sector, areas less sensitive to anesthetics.

“It is mainly the pain of uterine contractions that are very intense,” says Marie-Pierre Goumy, general practitioner and author of You will give birth in ecstasy (Mama Éditions, 2021). These subjective contraction pains vary depending on women. “Usually, they are felt at the abdominal level, but sometimes they radiate in the lumbar region and are known to be the most painful. »»

Painless childbirth, a recent revolution in the Western world

Different substances have been used for centuries to avoid pain (narcotics, plants, alcohol, various sedatives, etc.) with very random and potentially dangerous results (especially for the mother, but also for the child). The most emblematic is perhaps Chloroform (discovered in 1830) who accompanied Queen Victoria during her last two deliveries in 1853 and 1857.

But it is especially during the second half of the 20th century that modern painkiller techniques developed, that it is theepidural anesthesia, but also “painless” natural childbirth techniques. The one who had the most resounding echo on a global scale takes root in Russia and radiated through the work of a French: the “Lamaze method” (or “ASD” for painless childbirth) of French Doctor Fernand Lamaze (then taken up by Pierre Valley on his death) allowed Hundreds of thousands of women Around the world to appropriate the experience of childbirth thanks to education, breathing techniques and relaxation. The peak of its development attends a preparation for painless childbirth.

Proof that this method is still bearing fruit, the Dr Marie-Pierre Goumy testifies through his latest book of techniques to tame the suffering: “The whole first part of my work took place without pain thanks to the advice that I had received and set up. For this general practitioner, it was the preparation that allowed him to be confident and ready for childbirth. “I had studied and followed several preparations during my prenatal period, making it possible to understand the physiology of childbirth, for example the importance of emitting serious sounds during the contractions or of practicing movements to release the pelvis, the jaw as well as the perineal area. »Conclusion: she would have succeeded to give birth in ecstasyin particular via the help of endorphins and natural hormone neurotransmitters called oxytocin, secreted massively during work and which would bring an analgesic benefit reducing pain.

Some women also report having had a Obstetric orgasmthat is to say, an orgasm at the time of childbirth, due to the stimulation of nerves. But this concerns a tiny proportion of births (0.3% of women according to this study published in sexologies in 2013).

And then there was the rise of theepidural anesthesia. Developed in 1921, it developed massively in 1970 in maternities, in particular via the impulse ofanesthesologist Pierre Viars (Source: Le Monde). We owe this brilliant invention to a Spanish, Fidel Pages Miravédied two years later. Many women, disappointed with the uncertain effectiveness of painless childbirth techniques and guilt in the event of failure, turn to this method which has the merit of leaving women conscious during work, and allowing Medical staff a better follow -up of the biomarkers of the mother and the child. And above all, it makes it possible to intervene effectively in the event of complications (cesarean, forceps, etc.). In 2010, 70% of women have experienced a delivery under epidural analgesia (source: memory University of Rouen).

These are generations of women and children who have made a nice nose to the prophecy of Genesis.