Screaming Normality

In a recent doula group discussion, doulas with decades of experience between them were chatting about these sounds that they sometimes heard coming from other rooms, when they accompanied their clients to hospital (a rare occurrence at the moment due to Covid restrictions). It was noted that the doulas’ clients didn’t make these sounds and we wanted to work out why. It was also noted that many of us had experienced midwives dismissing or downplaying these sounds. Dismissive comments such as “she’s the one who didn’t get the epidural” are not uncommon, as is, “Best get an epidural now so you don’t end up sounding like that.” This left some doulas wondering how it’s possible to become desensitised to such suffering.

There was deep concern raised on the group that this type of suffering can become normalised on the labour ward, and that sometimes birthing women and people who are going through what at any other time would be recognised as a torturous experience are having their reality dismissed because they’re giving birth. When suffering becomes normalised, ways to reduce that suffering can also be forgotten. An over reliance on easy interventions, such as an epidural or opiates can mean that staff aren’t given the time to use other support options which require midwives to work solely with one birthing woman or person – which means higher staffing levels. While pharmaceutical pain relief is absolutely necessary sometimes, and must never be withheld from women and people who need it, it can actually make things worse for some.

Take, for example, the birthing woman who is screaming because she’s terrified and feeling alone and unsupported, rather than her pain being beyond her tolerance. Giving her an opiate may reduce her ability to communicate her fear, leaving her feeling just as scared, but still without the support that she really needed.

The consensus on the doula group was that with the advocacy that doulas bring, their clients were rarely without appropriate pain relief. Furthermore, if procedures were being done which was causing them avoidable pain, they were also able to intervene, if the midwife or doctor was sufficiently desensitised to the reactions of their client that they were not themselves stopping the procedure. Perhaps most importantly, with good support and care, birthing women rarely became so distressed that they experienced severe pain or anxiety from their labour.

A discussion also followed on ways that everyone in the birth room can make a difference to how the birthing woman or person feels, and how doulas, midwives and doctors have such a profound effect, either positively or negatively, when it comes to ensuring that uncontrolled pain or fear doesn’t happen.