Why does some pain fade?

Why does some pain last and other pain fade away? I’ve been chewing on this question for a few months now. Eight and a half to be precise. The experience of childbirth with my first child was certainly intense. But, as I sit here, eight and a half months later, I find it harder and harder to remember what the pain of giving birth felt like. Meanwhile, the pains in my ankle and neck persist from an injury twenty years ago this year. I can’t help but wonder, why?

To drug or not to drug

My labour lasted about 15hrs which I did without the use of pain killing drugs. The reasons behind that decision are perhaps best saved as a topic for another article. But that detail, experiencing the pain without drugs, stands out to me as I contemplate this question.

After my car accident, I received all the drugs. I vividly remember my drug induced reveries of floating through smoke machines and imagining myself as a fish in a fish tank as my family and friends gaped at me in silent shock as I lay in my hospital bed. Once the drugs kicked in, I didn’t physically feel much of anything.

Yet, all these years later, the pain from the injuries of that collision feel as fresh as the day they happened. Meanwhile, I spent 15hrs moving a seven pound baby through my cervix and out my vagina without a single pain killing remedy. That pain now a distant memory, far enough for me to think, that wasn’t so bad.

In the moment, of course the pain of labour was intense. The most intense, all encompassing acute pain I’ve ever experienced. For the duration of those 15hrs, every three to five minutes, I would let out a long guttural moaning sound for the duration of the contraction, a mix between a donkey’s bray and a yogi’s ohm. It was the only way I could get through the pain. I was sure the people in the parking lot could hear me, but that didn’t matter. Let them hear me roar!, I thought.

There was even a point, after about 12hrs of labour, when I realized that I still had to push the baby out, which I’d heard could take hours on it’s own, when I thought I might not make it. All I have to do is ask them to cut it out of me and it’ll be over, I thought to myself. I could end it now.

Yet somehow I made it through. Somehow, the experience was manageable, even forgettable. So what’s the deal?

As I said, I’ve been chewing on this question for some months now and here’s what I’ve come to understand:

Preparation is key

OK, so I understand that you can’t exactly prepare for a motor vehicle incident. I certainly could not have prepared for mine. Though I am certain that the time I spent preparing for childbirth, reading about it, discussing it with friends, family, midwives, doctors, and especially my doula, helped me to demystify the experience. To take away the fear of the unknown. Here’s an example.

I read a lot about what to expect from labour and delivery to help prepare myself for the experience. And I specifically recall reading about a moment during delivery called, most appropriately, “the ring of fire”. This is the moment when the baby’s crown starts pushing on and stretching the skin around the vaginal opening and perineum (the skin between the vagina and anus). This is a shocking sensation to say the least, but because I read about it, I was prepared for the feeling. I knew baby was getting close and I remember thinking, here comes the ring of fire, and did baby ever deliver!

That knowing, of being able to predict to a certain extent what I’d be feeling and when, made that experience much less frightening. Had I felt the “ring of fire” unexpectedly, not knowing what it meant or how long it would last, would have been, I’m sure, a frightening experience.

Acute pain has a reason and an ending

Why am I in pain? What did I do to make the pain so bad today? Why wasn’t it this bad yesterday? What’s wrong with me!?

These questions will drive a person crazy. And by person I mean me. It’s a common topic of conversation during my counselling sessions. I still have no concrete reason as to why I experience so much pain in my neck and shoulder (though we’re getting closer, more to come in a future article!).

Not knowing the reason for a sensation, especially a negative and debilitating one, can cause a spiral of toxic thoughts and feelings of doubt, guilt, shame, and fear. If I don’t know what caused the pain, I can’t predict it, nor can I mitigate or avoid it. I have to live in this never ending state of not knowing. That state of being causes all sorts of trickle down effects in the body. Particularly damaging is being perpetually on guard, holding a constant tension in the body from trying in vain to be prepared for the next shock of pain.

Labour and delivery, by contrast, has a very clear reason and ending. I know, more or less, what’s coming. I know that I’m going to be in a lot of pain. I know the stages of labour and that each one will feel different. And most importantly, I know the reason for all this pain and that it will end with the birth of my baby.

I don’t have to do this by myself

After my car accident I felt very alone. I had a loving family by my side and friends who came to visit me in the hospital, but eventually, everyone had to go back to work and back to school. Meanwhile I sat at home, hobbling around in my wheelchair with one arm in a sling, feeling left behind.

I didn’t feel like I had much support in the way one recovers from such an experience. Sure, I had doctors who fixed me up as best they could, a litigator who visited to ask a barrage of questions to help with the legal side of things, and an occupational therapist who came to get me back to work. But none of these people felt like they were there to help me process what had happened and learn how to live this new life. What was my life going to be like now? At the age of sixteen, I didn’t even know how to ask these questions, or that I even could or should.

I mostly felt like I was receiving the message that it’s best to get back to “normal” as quickly as possible. But, that normal didn’t exist for me anymore. I know that now. Yet I didn’t have anyone, or any kind of support network, that helped me to understand it then.

Knowing how much that experience affected me, and how lonely it felt, my husband and I planned to have a team of dedicated professionals to guide us through childbirth. Our midwives and Doula were by our side throughout the entirety of the pregnancy, birth, and two months after the birth to help us navigate this very new reality.

This incredible team helped us to prepare for not just the tangible aspects of having a baby: what to buy, what to bring to the hospital, what does all this poop and crying mean, etc. But also, how having a child changes you as a person. I learned about the terms matrescence and patrescence. Terms that help to describe the shift you undergo when becoming a parent. The same shift that we describe for children on their transition into adulthood as adolescence. You can’t tell an adult to “go back to being a child” anymore that you could expect a new parent to “get back to the way things were” pre-baby. This is a new state and one that needs a guiding hand(s) to navigate. Being on our own away from family, we needed to seek out that help that, perhaps, many people get from their nearby supportive families.

That support network made the healing process of childbirth more bearable than if we’d had to navigate it on our own. I could heal from the pains and wounds of the delivery in a low-stress state knowing that my support team would be checking in on me and that I could reach out anytime, day or night.

My mind needs healing also

Physical pain is nothing without the mind. This, I am acutely aware of now. Pain science is infinitely fascinating to me and has helped me to gather some understanding of the pain I experience.

I’m actively undergoing trauma therapy to help me process the car accident and the medical treatments that followed. It never occurred to anyone, including myself, to seek out counselling back then, when it was fresh. Lots of people get into collisions every day and many carry-on, even with serious injuries, to live a life without chronic pain or developing post-traumatic stress disorders.

From what I understand, this has a lot to do with your initial ability to cope with stress. I’m realizing now in adulthood, that I likely did not have a good way to deal with stress because I was never taught this important skill, like most people in my generation and those before us. There’s immense feelings that accompany a traumatic event. By not processing those feelings they stored themselves away in my mind and body to be triggered every time I feel stress. A never-ending spiral of stress > fear > tension > pain > stress > fear > tension > pain.

Counselling is helping me to break that cycle. It’s creating space in my brain so that when feelings of stress are present, I get a moment to choose my response rather than diving head first into the spiral.

For childbirth, we were able to both mentally prepare throughout pregnancy and process after the birth. During pregnancy, our Doula worked with my husband and I on our expectations and our fears. We talked about our birth preferences where our Doula expertly steered us away from unrealistic expectations and unnecessary instructions (“I don’t think you need to tell them not to hurt you, but maybe you could tell them that you’re afraid based on past experience”). We discussed worse case scenarios and how we could navigate those, including the need to give birth by cesarean, a particularly big fear of mine.

I also worked with my personal counsellor, especially on that last piece, to help me process tough feelings of intense fear and terror of having to go under the knife. All this preparation allowed me to approach the birth from a place of calm, knowing that I could handle whatever happened, whether it followed our plans or not.

After the birth, Josh and I processed the experience with the Doula, going through the whole event and checking to see if there was anything that wasn’t sitting well with us. I did the same with my counsellor.

So what have I learned?

These, I believe, were the key elements that helped me get through the pains of labour and delivery as if it were nothing more than a short bout of the flu. Something that comes on intensely and causes immense discomfort, but that passes over a short time and is mostly forgotten until the next incidence.

The major difference that stands out to me is the holistic care that I received during and after pregnancy compared to the reactive response I received after my car accident.

The mental health supports cannot be understated as well. During many of my current counselling sessions, old emotions, physical sensations, and even movements come up from somewhere deep down and forgotten to finally express themselves – at times forcefully – and find their way out of me. I can’t help but wonder what my pain journey would have been like had I received counselling after the accident. To help me process some intense emotions and guide me into this new reality.

I can’t change the past, but it does feel comforting to reflect and come to understand how I got here. I can only move forward with this information and hope to encourage others to heal their wounds while they’re fresh. Because ripping open old scars is so much more painful.