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This week, I read an article about labor and birth in Zimbabwe in the news. Apart from the $50 fee women need to pay to be admitted to hospital (a third of the average annual income), they are charged $5 for each scream.

Apparently, screaming is distressing to other laboring women as well as staff. Human rights organizations are already on this the practice could stop many poor women from giving birth in a hospital at all. In the west, we tend to think of screaming as an integral part of labor and delivery. Will you scream? 

Does labor and birth hurt lots and lots?

Some women describe labor and birth as the most painful experience of their lives, while others truly think it is no big deal. I remember thinking, "is this all?" when I had been in labor with my first child for about an hour. The pain was barely worse than your average menstrual cramps, and there was a nice recovery time between two contractions.

I had a homebirth, so no pain relief options were around. I generally have a high pain tolerance and really didn't care about that. Obviously, the pain got worse as labor went on. I delivered flat on my back, and yes, it hurt. Crowning, accompanied by that infamous "ring of fire", was worst. Afterwards, the tear lines also caused a lot of discomfort. My second labor was a lot easier. I knew what I was in for and didn't feel any fear. The baby was also smaller, so that could have played a role. I have experienced worse pain than labor and delivery. A kidney infection was probably the single worst pain I ever felt, and a broke bone comes in at a close second.

Everyone experiences labor in a different way. Pain relief options, and epidural anesthesia in particular, can help a lot if you find that the pain is just more than you think you can handle, or more that you want to deal with, period. No matter how high your pain tolerance is or how good your pain relief is, you will experience some pain. Perhaps a little, perhaps a lot. You will also forget about it. No, not right after birth but within a few weeks, as your body starts to heal.

Will you scream?

Most probably. I was pretty loud during my labors. At first, I tried to be quiet, and then I settled for conscious vocalizations not screaming, but pretty loud anyway. I hung a notice up on my front door while I was in labor: "Caution: Homebirth in progress". Why? So the neighbors wouldn't think my husband was beating me up :) and call the police. To be truthful, labor probably sounds a whole lot more like sex than like domestic violence. Some women are amazingly quiet during labor and some will actually scream. Your personality and temperament has something to do with your behavior during labor, but so does the pain you are feeling.

You can never quite tell in advance whether you are going to be a screamer. You know what? It does not matter.

There is no shame in screaming during labor, or birth. Some women find that vocalizing actually helps them concentrate, and that it can lessen the conscious experience of pain. Others find that the pain is exacerbated by fear, and that the combination of these two makes them scream. If you are worried about screaming during labor, you can discuss the matter with your OBGYN or midwife. The chances are that you will not be charged $5 per scream, as has been happening in Zimbabwe. You might well be offered pain relief, though. It is up to you whether you want to accept it or not.

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