How am I supposed to relieve the endless pain?
There was no doubt that the unbearable pain during childbirth was one of the most unforgettable memories for women. Although the expectant mothers knew the pain was inevitable, the intensity and endurance of the pain were far beyond what they had imagined. The endless physical pain which could not be relieved caused terrible suffering to the women. Naturally, this became a critical reason for psychological birth trauma.
The physical pain appeared throughout all the stages of labor and could inevitably lead to psychological distress. At the first stage of labor, the paroxysmal uterine contraction contributed to intense abdominal pain. At the second stage of labor, the mother needed to push as hard as they could to help to accelerate the birth process. The injury of the birth canal and the laceration of the perineum might cause great pain to the perineum during the process. The labor pain was far beyond what the women could bear and began to crush them.
"In the beginning, I could tolerate the pain. I even had some light sleep until noon. Then the pain intensified around 3 o'clock that afternoon. I felt like I was near death because of the pain. It could not be relieved, no matter what you do." (P18)
"The fetal biparietal diameter is longer than the others. The birthing process was accompanied by piercing pain when the baby came out. At that moment, I felt myself being torn apart. In general, I don't like to cry even if I am in pain, as I practiced yoga before. I knew how to relieve pain by breathing training. But this time, it made me break down during birthing. I yelled and cried out." (P10)
Inaccessibility to labor analgesia
Labor analgesia could help expectant mothers to relieve labor pain, but the technique has not been widely applied to women in China. Many hospitals do not provide the service of labor analgesia for women, largely as anesthetists are understaffed. Therefore, endless excruciating labor pain could not be effectively eased and might drive the women mad.
"I chose this hospital because I had known it could provide the service of painless childbirth. But when I was moved to the birth room, the doctor told me that the hospital had only one anesthetist who had the expertise of labor analgesia, and the very one was not available at the moment due to a business trip. I could not believe my ears when I heard it. The pain was so excruciating that I wanted to knock my head against the wall. Nobody had informed me that only one doctor could practice the technique in such a general hospital and that he was not on duty." (P8)
Can't I be weak?
The emotional vulnerability which resulted from heavy ideological baggage was considered as a psychological trauma for expectant mothers. It is generally known that childbirth is one of the most natural processes in the human world. And nothing can be more natural than vaginal birth to have a child. Furthermore, there is a widely acclaimed notion in China that one woman should be mentally strong once she becomes a mother. The conventional perspective is widespread both in the general population and among healthcare workers caring for these women. All people emphasized the point, but it seemed to take no count of the childbearing women's psychological states.
The families were repeatedly vocal of the fact that every woman had to go through all the sufferings to give birth to a baby, and that over the course of human history, all women have their babies with the same suffering. Thus, the expectant mothers had sort of frustration when they didn't feel heard and understood.
"Everyone said that it was not easy to give birth to a baby. My family kept telling me that some women spent two or three days to deliver the baby; some even took one week and that every pregnant woman had to endure the same pain to become a mother. You must bear severe pain on the body and mind throughout labor and birth. Such a saying may go well with others, but definitely not me. I don't wanna be like others. They all get me wrong, and nobody could understand my suffering. The birthing process was utterly physical and mental torture." (P3)
Burden of expectation
It is widely recognized by the Chinese that once a woman becomes a mother, she ought to reshape herself into a figure with great fortitude, perseverance, and resilience in order to go through all the difficulties and the hardship that face her ahead. Actually, the expectant mothers might not have a heart as strong as other people think they ought to have. In their opinion, a strong heart didn't fall in their lap like pennies from heaven, and they found it difficult to come up with such anticipation, which destroyed their mind. The repetition of the stereotype even made them felt upset and fragile.
"The doctor emphasized it is impossible for women to give birth with no pain over and over again. I was more disappointed when I heard that. Certainly, I did know childbirth came along with severe pain. I felt great pain already. Why did he still underscore the point? At least he should have given me some encouragement and confidence. In that situation, as a patient, the pain had maxed me out. I was fragile and didn't hope to hear the negative words." (P8)
Am I not important?
When gonging through the birthing process, the women usually thought they did not receive enough attention and support from family and medical staff. Family support, as one part of social support, played an important role in stabilizing emotions. However, the family members always insisted on what they thought was right rather than the women's inner demands. Moreover, the medicals were busy providing therapeutic services to expectant mothers, but they could not focus their mind on a certain woman during work time. Childbearing women felt neglected and forgotten by relatives and professionals, which gave rise to the negative experience.
Natural birth first
The family members, who were deeply convinced by the advantages of natural birth, did not respect the choices and decisions of the childbearing women. When the women in great pain begged for a cesarean section, the family refused the request and urged the women to hold onto natural childbirth. Such a rejection made the women sad.
" How I wish to die! The terrible pain continued for six hours. I didn't want a natural birth. I wanted to have a C-section. But my mother strongly expected me to give natural birth. She even lied to me that the doctor was absent." (P19)
"At that time, I felt abandoned by the world. Nobody cared about my pain and understood me. They all thought I was effeminate. I denied the words. I felt so painful, but my mother couldn't understand. How could she say that?" (P22)
When suffering the physical and mental torture of birth, the women were easier to feel neglected by their families, especially their husbands, as they did hope their families to take more care of them. Affected by the deeply-rooted prejudice that only sons could carry on the family line, some families were eagerly looked forward to having a male heir. What they only cared about was the baby's gender, dismissive of the women's feelings and thoughts.
"This pregnancy was unplanned. I didn't want another child. I wanted to be free. But my family greatly hoped to have a boy to carry on the family name. They insisted that you won't be laughed at until you have a son." (P2)
"After surgery, I was left alone approximately for 20 minutes at the door of the operating room. I didn't know where my husband and mother were. I felt angry because they were chatting when the doctor tried to reach my family." (P12)
Neglect by the medical staff
The medical staff 's every move was watched and affected the childbearing women during birth. The women thought they deserved the accompany and encouragement from the medical workers. But in many circumstances, medical workers were busy getting their job done. When lacking enough care from doctors, nurses, or midwives, women would lose confidence and feel being left in the lurch without any psychological support.
"The medical staff left me hanging. They changed shift at eight in the morning. The handover meeting took more than one hour. My call for them was met with ignorance. I felt like being abandoned." (P6)
What uncertainties are waiting for me?
The women would be faced with many uncertain situations during labor and birth. The fear of unknowns made them regard childbirth as a disaster. Meanwhile, a multitude of objective factors could not be predicted before birth, and emergencies were common during birth. Childbearing mothers usually worried about terrible things that could go wrong and lost their confidence in handling unexpected conditions.
The expectant mothers could not independently decide the mode of birth as they originally planned. A medical emergency could happen during the birthing process as a result of antenatal objective factors, as in the abnormal positioning, or cesarean history, etc. On some occasions, the expectant mothers had no choice but to shift to a cesarean section from a failed vaginal birth attempt, though they had strained themselves through the long hours and the tormenting pain. These women felt hopeless as they had to sustain dual pain, including from a failed natural childbirth attempt, and from a cesarean section.
"I was almost collapsed at that moment. The birthing process was awfully lengthy, and I still failed to push my baby out. The unknown situation plunged me into terrible fear. I dared not risk my baby's life and had to give up. It compelled me to resort to C-section at last. I suffered a lot. I felt squashed and cried inside (the operating room)." (P3)
During the whole labor process, the expectant mothers usually felt apprehensive because of perceived dangers threatening themselves or babies. They worried that their underlying diseases or low labor force might become an obstacle to a successful birth. Besides, the women always considered fetal safety first so that the preterm birth, fetal distress, and other unfortunate situations also made them full of fear.
"The surgical procedure took a long time. I lay on the bed uncomfortably. The doctor told me that my bladder adhesion was quite severe due to the previous cesarean section. I lost my composure all of a sudden. I felt scared and nervous because I didn't know what that meant to me." (P11)
"I was not in the hospital when the amniotic fluid leaked. I couldn't calm down and was panicky. It frightened me that the baby appeared to rush out so early. I worried that my baby didn't fully grow. Besides, I didn't know how to make the choice of cesarean section or natural birth." (P10)
Under the influence of other expectant mothers, the women were easier to feel stressed and fearful. When waiting in the labor room, the women witnessed other expectant mothers' negative experiences and emergency circumstances. They were afraid that the same thing might happen to themselves and had no control over the process, which rendered them into emotional incontinence.
"I felt horrible when witnessing the childbirth process of other women. Firstly, I found that I was older than these first-time mothers. Moreover, I had my first baby by cesarean section, which resulted in the scarred uterus. When I saw they had a rough time, I felt more scared." (P22)
"The process of cervical dilation was like a nightmare. I still feel scared up to now. Especially, the mothers shared the same room. When they yelled during cervical dilation, I felt petrified. I didn't know how long the condition would last and how serious the pain would be." (P6)