The Lie of Pain: Reclaiming Birth from Fear and Misunderstanding

This is your body, your baby, your birth, your uterus & your power. It's all YOU.

Pain in birth is not what you think it is.

It’s not a punishment. It’s not failure. It’s not something to be feared, numbed, or “fixed.”

Sometimes it isn't even present!

Too often, pain in labor is framed through a medical-industrial lens that was never made for us. A lens that teaches us our bodies are broken, that birth is dangerous unless controlled, and that intensity must be managed with intervention.

When we return to the wisdom of our ancestors and the evidence of our biology, another truth rises: Pain is often not the problem. Fear is.

Reframing Pain as Power

A twin home birth: The birth of Ephraim Matteo, twin B.

Labor is movement. Labor is transformation. The uterus, our strongest muscle, contracts with purpose. These sensations, while intense, are a sign that the body is working as it should. There is wisdom in each wave. Pressure in labor is not the same as pathology. What many experience as "pain" during labor is often misunderstood. It's not pain like injury. It's power. It’s stretching. It’s the body opening. It’s the baby descending. When we fear that power, we resist it. And that's when true pain intensifies.

The Fear-Tension-Pain Cycle

In the 1930s, English obstetrician Grantly Dick-Read introduced the Fear-Tension-Pain cycle to explain how emotional responses directly affect physical labor. While we don't give long deceased white men credit for anything, because Indigenous and African midwives understood all of this, it doesn't negate these truths. When a birthing person feels fear, their body tenses up. Tension restricts blood flow to the uterus, which can increase pain and slow down labor. The increased pain creates more fear, and the cycle continues.

This is more than theory. It's observable. A laboring person surrounded by unfamiliar, unsupportive faces will experience labor very differently than one surrounded by warmth, rhythm, and trust.

As doulas, we are trained to interrupt that cycle. To create calm, rhythm, and connection that replaces fear with grounding.

Gate Control Theory: The Body's Built-In Pain Filter

Go within; set the scene for your birth & ensure your support team understands this importance of environment.

The Gate Control Theory of Pain tells us that pain signals must pass through "gates" in the spinal cord before reaching the brain. These gates can be opened or closed based on a variety of factors like touch, pressure, movement, or even mindset. This is why methods like massage, counterpressure, or warm water provide real relief in labor. They don’t block pain. They compete with it for attention in the nervous system and often close those gates before pain is even fully registered.

Oxytocin: Nature’s Own Labor Hormone

Oxytocin, sometimes called the “love hormone,” is the biochemical powerhouse of labor. It fuels uterine contractions and enhances feelings of trust, safety, and connection. When you’re hugged, kissed, or touched gently, oxytocin rises. When you feel safe, calm, and held, it floods your system.

Unlike synthetic Pitocin, which creates stronger, longer contractions without the emotional warmth, natural oxytocin supports both labor progress and comfort. Studies show that laboring people in supportive environments produce more oxytocin and experience shorter labors and fewer interventions (Uvnäs-Moberg, 2014).

So yes, oxytocin is natural pain relief. And when doulas help protect that hormonal flow with dim lights, loving touch, and steady presence, they help keep birth in balance.

Natural Comfort Measures for Labor

Double hip squeezes are popular because they work, not because it's trendy. It's important to hire someone who knows where to put their hands, and equally as an important, when to use them and when to sit on them.

There is no one-size-fits-all approach to comfort in labor. What matters most is choice, rhythm, and respect. Here are some of the tools and techniques doulas and birthing people across generations have used to ride the waves of labor:

• Wooden combs: Held in the hand to stimulate acupressure points and distract the brain from contraction intensity

• Ice cube practice: Holding ice during pregnancy to practice staying with intense sensations using breath

• Double hip squeezes: Instant relief for back labor by opening the pelvic outlet and applying steady counterpressure

• Rebozo sifting: A traditional Mexican practice to relieve tension, reposition baby, and offer comfort

• Warm water: In the shower or a birth tub, water offers weightlessness and relief

• TENS unit: Gentle electrical pulses to lessen perceived pain, especially in early labor

• Low, open sounds: Humming, moaning, or chanting helps the cervix open and grounds the nervous system

• Essential oils: Lavender to calm, clary sage to strengthen contractions, used with care

• Herbal compresses and teas: Like raspberry leaf, nettle, and ginger root to nourish and support

• Movement and position changes: Rocking, squatting, leaning, dancing. Always move with labor, not against it

• Visualization and affirmation: Mental rituals, ancestral prayers, and powerful self-talk to shift perception

Pain escalates when birthing people are told to be still, quiet, and passive. That’s not birth. That’s control. Birth needs space. Birth needs breath. Birth needs movement.

Holding the Line in a System That Profits from Your Discomfort

Hospitals are not neutral spaces. They are institutions — and within them, pain is often pathologized, not honored. For Black and Indigenous birthing people, the stakes are even higher. We know that Black women in the U.S. are 3 to 4 times more likely to die from pregnancy-related causes than white women, regardless of income or education (CDC, 2023). This is not about individual health — it is about systemic neglect, bias, and the routine dismissal of our pain.

In the hospital, you're more likely to be told that you need pain medication than you are to be asked how you want to labor. You're more likely to be offered an epidural before you're even in active labor than to be supported in changing positions or using movement to cope. The overuse of epidurals, Pitocin, and forced immobility directly interrupts the natural hormonal cascade of birth, particularly the flow of oxytocin — our body’s own “pain relief” and bonding hormone. The more interventions are stacked, the more likely a cascade of complications will follow.

This is why it is vital to prepare in advance, to bring a doula or strong advocate, and to be clear: “I plan to labor unmedicated, and I will ask if or when I want medication.” Say it early and say it often. Ask for support using natural comfort techniques first — like hydrotherapy, position changes, hip squeezes, aromatherapy, or massage. Ask what non-pharmacological options they have on hand. And remember, informed consent is your legal right — no one can touch your body, place an IV, or insert anything without your explicit and ongoing consent.

Pain does not mean something is wrong. But in a system designed to monitor liability over physiology, your discomfort will often be used as leverage. This is why full-spectrum doulas and community-centered education matter so deeply — because once you know how birth actually works, the medicalized version starts to look like the illusion it is.

The Power of Trust

Doulas trained in full-spectrum, traditional birth work understand the physiological and spiritual nature of labor. We are not just support people. We are protectors of peace, rhythm, and remembering. We help you come back to your body, your breath, your baby. We help you reclaim what’s been stolen by centuries of medical racism, colonization, and fear-based birth practices.

At The Better Birth Worker, we don’t teach doulas to manage labor pain. We teach them to understand it. To honor it. To support birthing people in shifting the story from one of suffering to one of sovereignty.

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Citations & Sources

1. Dick-Read, Grantly (1942). Childbirth Without Fear. Harper & Brothers.— The foundational text introducing the Fear-Tension-Pain cycle, emphasizing how fear increases muscular tension and labor pain.

2. Melzack, R., & Wall, P. D. (1965). Pain mechanisms: A new theory. Science, 150(3699), 971–979.— The original publication describing the Gate Control Theory of Pain, showing how pain is modulated by non-painful stimuli like touch and movement.

3. Uvnäs-Moberg, Kerstin (2003). The Oxytocin Factor: Tapping the Hormone of Calm, Love, and Healing. Da Capo Press.— A comprehensive exploration of oxytocin's role in labor, bonding, and natural pain relief. Grounded in decades of neuroendocrine research.

4. Buckley, Sarah J. (2015). Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. Childbirth Connection.— A highly cited, evidence-based report detailing how oxytocin functions in physiological birth and the disruptions caused by interventions like Pitocin.

5. Simkin, Penny & Bolding, Anne (2004). Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. Journal of Midwifery & Women’s Health, 49(6), 489–504.— A respected clinical overview of comfort measures used by doulas and midwives, including touch, sound, positioning, and hydrotherapy.

6. Hunter, Lauren J. (2020). Reclaiming Our Medicine: A Journal for Black Birthworkers. Self-published.— A culturally centered reflection on Black birthwork, wisdom, and resistance to medicalized narratives of pain and pathology.

7. Gaskin, Ina May (2003). Ina May's Guide to Childbirth. Bantam Books.— While used selectively, Gaskin’s narrative work includes client birth stories that illustrate how unmedicated labor can be transformative and manageable when trust and movement are present.

8. Kozhimannil, Katy B., et al. (2013). Doula care, birth outcomes, and cost savings. American Journal of Public Health, 103(4), e113–e121.— Demonstrates how doula support improves outcomes, lowers intervention rates, and enhances comfort and satisfaction in labor.

9. Romano, Amy M., & Lothian, Judith A. (2008). Promoting, Protecting, and Supporting Normal Birth: A Look at the Evidence. Journal of Obstetric, Gynecologic & Neonatal Nursing, 37(1), 94–104.— Reviews physiologic birth practices, highlighting the importance of movement, continuous support, and natural coping mechanisms.

10. Chalmers, B., Mangiaterra, V., & Porter, R. (2001). WHO Principles of Perinatal Care: The Essential Antenatal, Perinatal and Postpartum Care Course. Birth, 28(3), 202–207.— WHO guidelines affirming that non-pharmacological labor support and traditional comfort tools are globally recognized as effective and evidence-based.