6. “What if I can’t handle the pain of birth?”

I was pregnant with my second child, sitting on the cozy couch in my therapist’s office, talking to her about how I kept waking up in the middle of the night. I would lie there, midnight air closing in around me, and worry about my upcoming birth. After a traumatic first birth experience, I’d switched providers and birth locations and started preparing extensively for an unmedicated birth. But still, my brain would wake me up when the rest of our house was still, and it would spinspinspin around: how will you handle the pain? What if you’re out of control? What if you just can’t take it anymore? What will you do? How will you survive?

I became consumed with trying to envision my way through this mess of thoughts. If I could just picture it perfectly — the pain, what it would feel like, exactly how I would cope — then I would know for sure I could make it through. But as everyone who’s ever experienced anxiety knows, no matter how much your brain runs over future scenarios in search of certainty, you can’t see what hasn’t happened yet. 

It was this struggle to glimpse the future that came up in that day’s therapy session.

“How can I know I’ll be able to do it?” I asked my therapist. “What if I can’t handle the pain of unmedicated birth?”

I was ready for her response. I knew what she was going to say. She was going to look right at me and tell me she had so much faith in me. She was going to say she believed in me 100%, that I’d find a way no matter what. She was going to give me the courage I was afraid I couldn’t find within myself.

But then she said, “You might not.”

At this point I was pretty sure she’d suddenly acquired some brain-eating amoeba that made her talk nonsense. 

Or maybe I’d just heard her wrong.

Unluckily for me, she clarified in a very non-brain-eating-amoeba way, “You might not be able to handle it.”

I was stunned. Here I was baring my soul to her, digging into what I thought were my deepest birth fears, looking for encouragement and support and you-can-do-it-ness. I wanted someone to tell me that I had it in me, that I was going to do it without pain medication, just the way I wanted to.

Shocked, I moved into logistics with her, talking about how I’d have to transfer if I needed an epidural, how much time that would take, how I’d have to navigate that decision. All things I didn’t want to think about or do. 

I remember something else she said to me in that conversation too. When we were talking about what the pain would be like and what I would do, she said, “I’d hate to see you hold yourself hostage to all that pain.” By “all that pain,” I don’t think she meant just the physical pain of birth. I think she meant the pain of a scenario where I could be truly suffering, completely unable to cope in any way because I was holding myself to a vision that no longer matched my reality. 

How many times do we do that in our lives? How many times do we cause ourselves great pain because we cling to our imagined version of something instead of acknowledging that what’s actually going on is different from what we expected?

I’m not talking about being go-with-the-flow here. I’m not talking about appreciating your birth merely because you and baby emerged from it alive (as if “healthy mom, healthy baby” is all we should strive for — and of course, for many women, particularly women of color, we’re not even meeting that bar). I’m talking about discovering the deep core of what you’re hoping for in your birth experience, acknowledging the loss you may feel if your reality doesn’t match your expectations, and then digging even deeper to find the strength or realization or transcendence or belief that you need in that moment to keep going. 

Maybe you pictured yourself laboring away, warrior woman style, pulling your own child from your body, but when you go into labor, it’s been two days since you last slept, and you have to access a strength that goes beyond the physical. 

Maybe you imagined yourself pushing comfortably with an epidural, totally present and ready to meet your baby, only to have your epidural fail, and you have to find a way to move through a blinding pain you weren’t expecting or prepared for.

Maybe you saw yourself on hands and knees, birthing your baby in a primal way, only to find yourself sick with exhaustion and nausea, on your back in bed, and you have to draw on some inner resource to remind yourself that your body truly is enough to do this.

Maybe you imagined being in the hospital, a whole medical team around you, only to find yourself in the bathtub of your own home, baby crowning, and you have to summon courage and faith in yourself you didn’t know you had.

Maybe you thought you’d be at home, in your own bed, birthing baby into your partner’s arms, only to find yourself in the operating room, staring into the cold bright light, and you have to ask more of yourself than you ever have before.

There was something hidden in my therapist’s words that I missed at first. What I heard was, “Maybe you won’t do it,” but what she was really saying was, “You won’t *only* be able to do it if it looks that one way.” Birth doesn’t have to look or feel how we expect to be a powerful, positive experience. We don’t have to control or predict everything. Maybe we can let go of that. Maybe it’s in the letting go of that that we’ll have our most powerful birth experiences yet. 

And as it turns out, that’s exactly what happened with mine.