Labor and birth are powerful, life-changing experiences, and pain is often one of the biggest concerns for expecting parents. In this episode, we reframe your perspective on labor pain by exploring why childbirth is challenging, how evolution has equipped us with adaptations, and what actually happens during each stage of labor. Learn the role of hormones, your baby’s contribution to the birth process, and the limitations of pain research. Also learn about the many factors that can influence your perception of pain, like support, environment, and positions, and the medical and non-medical interventions available to manage it. By the end of this episode, you will have a new perspective to help you feel prepared, capable, and confident as you approach your birth.

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Labor and Birth Vocabulary

Pain is the last thing you want to think about when you picture meeting your baby. The word pain carries negative associations, and for that reason, some people choose to avoid it. Some practitioners and expecting parents prefer words like discomfort instead of pain, or surges or waves rather than contractions. Whatever vocabulary you select, labor and birth can still be physically demanding and challenging. In this episode, I use the term’ pain’ because it is the most commonly used term in research and medical literature.

Reframing Pain

Labor and birth almost always involve some level of pain, although the experience is different for everyone. You may hear stories about pain-free births, but most expecting mothers do feel pain or discomfort as part of the process. In Western culture, movies and TV often portray childbirth as an extreme, dramatic event where the mother screams in agony. That image makes for drama on screen, but it does not reflect everyone’s reality. When you understand what to expect and why birth can involve pain, you can approach labor with more calm, clarity, and confidence. Even if the word pain feels uncomfortable to you now, by the end of this episode, you will have a better understanding of labor pain and feel less fear or negativity around it.

How We Feel Pain

Pain starts when nerves in your body send signals to your brain. Your brain interprets those signals and creates the feeling of pain. Because every brain is unique, pain is subjective, and people experience the same sensation in different ways. For example, one person might feel intense pain from a small cut, while another barely notices it. What you feel depends not only on the physical sensation but also on your emotions, your past experiences, your environment, and even your expectations.

Theories as to Why Childbirth is Difficult or Painful

It feels counterintuitive that something so essential to our survival would be difficult and come at a high cost. Historical texts, as far back as we can trace, describe women experiencing pain during birth. Some religions teach that childbirth pain was a punishment for Eve’s eating from the tree of knowledge of good and evil (Genesis 3:16 ). Beyond cultural or religious perspectives, researchers have studied scientific reasons rooted in human evolution and biology that help explain why labor and birth involve pain.

The Obstetric Dilemma

Researchers first proposed the concept of the obstetric dilemma in 1960 to explain why childbirth in humans is more challenging than in other primates. They argued that humans made a biological trade-off. When humans began walking upright, their hips became narrower, and the shape of the pelvis and birth canal changed. At the same time, babies’ brains grew larger, which meant their heads got bigger. A smaller pelvis in the mother combined with a bigger head in the baby made childbirth more challenging.

Supporters of this hypothesis also suggest that humans had to shorten the length of pregnancy so babies could be born while their heads still fit through the birth canal. This would explain why newborns rely so heavily on parents and why people often refer to the first three months of life as the fourth trimester.

Constrained Maternal Metabolism

Not everyone in the scientific community agrees with the obstetric dilemma, and instead, some researchers propose that gestational length is a function of constrained maternal metabolism. Meaning a mother’s body can only support a baby’s growth up to a specific energy limit, so labor begins when the baby’s needs exceed what the mother can provide.

The Move from Nomadic to Agricultural Societies

Some researchers point to lifestyle changes about 10,000 years ago as another reason birth became more difficult. When humans shifted from living as nomads to settling in farming communities, their diets changed. People became shorter in height, and shorter stature often comes with a narrower pelvis. At the same time, carbohydrate-rich diets led to larger babies. A smaller maternal pelvis, combined with bigger babies, added to the challenges of childbirth.

The Evolution of Childbirth

Although researchers may not agree on a single theory, everyone agrees that childbirth comes with challenges. Th