Form and Function

I've recently started reading the classic book Childbirth Without Fear, first published in 1942, and written by Dr. Grantly Dick-Read. This book first formalized the theory that pain in childbirth results primarily from the presence of fear in the birthing woman and first named the Fear-Tension-Pain Syndrome that is still commonly taught in prenatal childbirth classes today. I'm only a portion of the way through the book and only have his say-so on certain anatomical information presented as we haven't gotten as far as the uterus in class, but with the heavy emphasis on the importance of the state of the nervous system during birth, I thought the ideas presented in the book are relevant at this point. I will try to summarize the most important points as he presents them:

1. No other normal physiological process of the body is expected to be or is experienced to be painful. Only when bodily processess exceed physiological norms is pain experienced.

2. The parasympathetic nervous system controls the longitudinal muscle fibers that contract to cause the cervix to dilate and the baby to move down the birth canal. The sympathetic nervous system controls the circumferential muscle fibers that cause constriction of the uterus and restriction of the birth process. Also controlled by the sympathetic nervous system is the muscle tissue that surrounds the blood vessels serving the uterus.

3. In the absence of fear, the fight or flight response of the sympathetic nervous system is inactive, allowing birth to progress smoothly and according to the physiological norms of this body function.

4. In the presence of fear, the sympathetic nervous system cause the circumferential muscle fibers of the uterus as well as muscle fibers that surround the uterine blood vessels to contract, causing excessive muscle tension between the longitudinal and circumferential fibers as well as restricted uterine blood flow. These effects result in pain.

I'm rather impressed by the many ways Dr. Dick-Reads observations of modern obstetrics apply as clearly today as they did in 1942 and am greatly enjoying reading the detailed, original explanation that forms a primary foundation of the childbirth program I teach. A good read!