Giving birth is perhaps one of the only occasions in a woman’s life where she is permitted to feel pain. It is universally accepted that childbirth is an abhorrent experience — in the Judeo-Christian worldview, it is literally a punishment from God. Some don’t even survive it.
Note: The word woman is here used to describe someone who has been socialised as female due to being born with the reproductive equipment associated with childbearing. Not all women have wombs, not all those born with wombs are women.
I went through a stage towards the end of my pregnancy where the mere mention of giving birth would make me cry. It wasn’t so much that I was scared or upset by the prospect — if anything, the thought of an end to what had, until then, been an appalling pregnancy was more than welcome. No, I wasn’t scared; I was confused.
In the lead up to giving birth, most women will have already endured more than a decade of — sometimes crippling — period pains. I spent more than fifteen years perfecting the art of ignoring the pain that arrives in waves at the end of each month. How could I suddenly unlearn half a lifetime’s worth of social indoctrination?
Knowing that this great pain was drawing inevitably nearer, my biggest concern was that I wouldn’t know how to recognise the pain when it finally came.
How does my pain measure up against yours?
It sounds absurd, but consider it for a moment. What is pain? Have you ever tried to explain period pains to someone without a uterus? Have you ever tried to explain being kicked in the balls to someone without testicles? We often describe the pain we feel by comparing it to something more universally recognisable — like a knife being twisted in your gut. But how many of us have actually been stabbed in the stomach?
Pain is both a deeply personal experience and something we all share. It is also something very difficult to measure objectively.
When I entered the birthing room, I was offered, for the first time in my life, a relatively objective measure of pain. From the moment my contractions started, my heart-rate and blood pressure were on display beside me. Each time a contraction came, both would shoot up, and the midwife would nod as if to validate my experience.
I couldn’t help but wonder, as the opiates set in and I could relax a little, what would my vitals look like if I were hooked up during my period? What would it feel like to have a member of the medical establishment — or anyone, for that matter — acknowledge my monthly pain?
A gender-based pain spectrum
Upon leaving my own mother’s uterus, I was assigned a gender, just as she, her own mother, and her mother’s mother were before me. Thus began the process of socialisation designed to teach us to variously ignore and suppress the bodies we were unfortunate enough to be born into.
One of the first things we are taught to suppress is the space between our legs, and the pain associated with it.
When a man gets kicked in the balls, the entire world groans with him. It is a truth universally acknowledged that a blow to the balls is in need of some serious sympathy, usually expressed vocally, for all to hear. A guttural oompf to let him know we care. Women’s pain, in contrast, is recognisable for its silence. By the time we hit puberty at ten or eleven years old, we begin our training in denying our pain.
Pain becomes a secret ache between our legs, the disgusting fact of being able to bleed for a week each month without dying. It forces us to squeeze our knees together to stop from crying out, pop paracetamol and ibuprofen alternately just to make it through the day. It’s that horrendous dragging feeling towards the end, which no painkiller seems able to mute.
The society-wide denial of female pain means women with serious health concerns, like endometriosis, are left undiagnosed for decades. Endometriosis affects as many women as diabetes but is far less likely to be diagnosed, treated, or even acknowledged.
Where men may refuse to visit a doctor for pain or problems associated with their genitalia out of embarrassment — which is a gender-based problem in its own right —women think their pain is normal.
Women compete against those without wombs
There is, of course, a certain pragmatism in schooling young girls in the art of ignoring pain. The stomach cramps, headaches, lower back pain, and tender breasts that accompany the last phase of a woman’s monthly cycle will reoccur, there’s no avoiding it. While being on your period might be enough to get you out of swimming class, it’s not enough to excuse you from performing well in all other aspects of your life. Perhaps it’s better to just ignore it?
Though girls still manage to outperform boys in school, chronic pain impacts their ability to concentrate. According to the University of Bath in England, period pain (dysmenorrhea) affects 40% of women, is often severe, and can seriously dampen cognitive performance.
Yet women are still expected to compete both academically and professionally against those who do not experience chronic, recurring pain on a monthly basis for forty years.
Asian women are winning at period politics
In the debate on providing paid menstrual leave in the European Union, it has been argued that a ‘blanket’ menstrual leave policy categorises everyone who menstruates as ill, thus perpetuating sexism.
However, in several Asian countries, it is not only culturally appropriate to take a day off for period pains, the right is legally protected. In South Korea, women are entitled to paid menstruation leave and the right to claim compensation when this leave is not used. When a labour dispute arises over menstruation leave, the courts often side with the women, forcing companies to pay and setting a precedent for future cases. In Indonesia, those who menstruate are entitled to two days of leave per cycle and in Taiwan, women are given an extra three days paid sick leave per year for menstruation.
While I was working for a unit of the Chinese government between 2013–2016, it was considered completely normal to take a day off or to leave work early when suffering from period pains. The women in my office would speak openly about their menstrual cramps, with both other women and men, without taboo. In 2016, Olympic swimmer Fu Yuanhui shocked western audiences when she openly admitted that being on her period had impacted her performance in Rio.
Not all pain is considered equal
Even within this gendered denial of pain in western countries, there are inequities, because pain is necessarily political.
The Covid-19 epidemic has uncovered some distasteful truths already well-known and documented within both the communities affected and intersectional feminism. Alongside structural discrimination within the medical system, racial biases dictate how pain is perceived in both medical and non-medical settings.
A black patient with the same level of pain and everything else being accounted for was much less likely to receive an opioid prescription than a white patient with the same characteristics.
Astha Singhal, Boston University
In the UK, Kayla Williams, a young mother of three, was told she was “not a priority” and forced to return home, only to later died from Covid-19 complications. As Nicole Vassell explains, the medical profession in western countries has yet to shake off 18th Century beliefs about the pain tolerance of black people. Vassell goes on to cite a report by the Association of American Medical Colleges, which found that half of white trainees genuinely believed the myth that black skin is thicker or has fewer nerve endings.
Black women are 3–4 times more likely to die from complications in pregnancy and childbirth, and they face a double disadvantage when it comes to pain treatment.
One study, cited in a report entitled The Girl Who Cried Pain, looking at post-operative pain in children found that boys were more often given codeine after an operation, while girls were only offered paracetamol. Black patients are less likely to receive opioid pain medication than white patients due to racial profiling over drug use.
Why don’t we support women in pain?
An awful lot of what girls and women are expected to endure as part of normal life is pretty damn painful — even for those who don’t decide to procreate. Yet, for the vast majority of us, this pain isn’t even socially acknowledged, let alone validated by policies to support us as we suffer it. Even the European Union, one of the most progressive regions in the world for labour rights, won’t offer menstruation support policies.
Sitting here, with my body winding down from a particularly painful week shedding my womb-lining, I’m not entirely sure whether I even have the energy left to fight for it. And perhaps therein lies the problem.