"The pain I experienced was most overwhelming. Despite my being prepared for a painful labour, I just could not believe how severe the pain could be." - Midwife

"From this battle will come some good, the satisfaction of overcoming pain. The achievement of happiness and peace, of life in spite of it. This is quite an achievement, an achievement very special, very personal - a feeling of strength, of inner strength, which has to be experienced to be understood." - Jonathan Wilson-Fuller.

As if the mechanism of pain was not complicated enough, its expression is even more enigmatic. Some individuals reveal their pain and suffering more freely than others. In other words, the vocal expression of pain is often suppressed among animals during an otherwise vulnerable period in their lives.

 Contrary to popular belief, natural labour does not seem to favour one society more than another as far as pain and suffering is concerned. Labour pain is felt by women of all cultures. The notion that women who are untainted by civilisation deliver babies painlessly and effortlessly is a figment of the imagination. As long ago as 1945, a study carried out among 64 primitive societies noted that:

"The popular impression of childbirth in primitive society as painless and easy is definitely contradicted by our observations. As a matter of fact, it is often prolonged and painful."

 Several other studies have come to the same conclusion.

There are, however, differences in the expression of pain between different cultures and ethnic groups. Some cultures, for example, encourage women to make a noise during labour while others condone silent stoicism (the 'grin and bear it' or 'stiff upper lip' brigade). Moreover, different societies seem to have different expectations regarding labour pain. American women, for example, when compared with women from Holland, expect labour to be more painful and also anticipate receiving more analgesia.

The ways in which we respond to pain, therefore, are both complex and personal. Some women look upon labour pain as a personal challenge, like running in a race; something to try and overcome by using their own resources and will power. Those who succeed justifiably feel a sense of pride and achievement afterwards. In contrast, other women find that labour pain is so overwhelming that they are unable to think about anything else. For them, such an experience is unlikely to be emotionally fulfilling.