Tales of Birth Reframed: Part 3 – The Case of the Missing Pain Endorphins

Once upon a time, a labor had picked up with frequent contractions.  The laboring parent exclaimed, “WAIT!  What was I thinking?  Why did I do this?  Why did I want a natural birth?”  

But all of a sudden the baby had shifted and descended and along came some hormones called pain endorphins (and a bit of the love drug oxytocin).  Pain endorphins began to pump through their system and match that intensity, and all of the sudden, one could roll with it, roll with it, roll with it.  There was a rhythm.  The level of the pain endorphins caught up with the level of intensity or pain.  After some time of laboring, all of a sudden the intensity of labor seemed to climb again.  Now the words used seemed to get more serious,  (I censored them for you, don’t worry)  and the person birthing wasn’t sure what to do or where to be as it seemed to change from moment to moment.  Eventually, the pain endorphins finally began to catch up to the intensity.  One could roll with it, roll with it, roll with it.  

Now, these incremental changes would rise with pain on one side and endorphins on the other and they didn’t rise all the way to the ceiling.  However, the rhythm was kept where each was met by the other.  The pain would rise and the endorphins would eventually follow.  

Now, this is an example of a symmetrical labor pattern and how when the labor progresses, the endorphins rise to meet it.  

This may not be a case where the baby hasn’t engaged yet.  In fact, the person birthing might be in their head and possibly swearing and in pain on top of the pelvis.  It could be caused by the baby being on the pubic bone or the sacral promontory.  The labor pattern might be irregular and coming and going along with the intensity but it hurts.  This baby is likely not engaged and the fact that the birthing parent is in their head is a big clue as there is only room for one head in the pelvis (as Gail Tully so aptly said)… and it is not the birthing parent’s!  This baby needs to engage and descend for labor to progress.  The hormones that are created when the baby’s head meets the pelvic floor are not showing up as reinforcements for the other hormones. 

But there is another scenario of how the endorphins can be missing.  A person can get rid of the pain.  If there is no pain or intensity, there may not be an endorphin response.  When the intensity after an epidural disappears, it reduces just like the pain.  If the epidural is turned off, these endorphins have to return from the bottom up.

Sometimes someone is laboring and they are having a difficult time coping.  In fact, maybe they just want to run and escape.  This position doesn’t work or the tub doesn’t help or maybe they just don’t know where to go or what to do because it sucks.  This gate of terror, doubt and unknowing may just be that this pain endorphin cycle hasn’t been completed.  Maybe it is just partially through that cycle and it just happens to be that the intensity has risen and the endorphins have yet to catch up so one can roll with it, roll with it, roll with it.  

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