I knew as soon as I saw my doctor adjust his glasses and furrow his eyebrows that something wasn’t right. I tried to dismiss my worry and turn my attention back to the slimy little body laying on my bare chest, taking in the milkiness of his eyes as they gazed at mine.
I already knew I hated this part, and I was dreading it even more after my last birth. When my placenta wouldn’t expel itself after that birth, my doctor had to help it along manually, which is as horrifically painful as you might imagine. Even as someone who’d had multiple births without pain medication, I could attest that it was the most physically excruciating few moments of my life.
So seeing that same doctor, the one whom I’d never seen in any of our dozens of appointments over multiple pregnancies ever waver from his almost eerily unflappable demeanor, start to look… worried? My alarm bells were starting to ring.
The pain in my uterus and entire lower half of my body was picking up steam, and my breath was taken away each time the doctor would push down on my abdomen, willing the stubborn organ to deliver.
Without a word, a nurse picked up my hand and started placing an IV. The sting of the needle felt like nothing compared to the swirling ache that had consumed my body. “This will help,” she told me, “We’re going to help the pain.” I didn’t know what was flowing into my body, but I was grateful for it, hoping that it would ease this horrific throbbing.
I waited for any semblance of relief. It had escalated to feeling a thousand times worse than delivering my baby moments before. And now, no matter how hard I tried, I couldn’t focus my eyes on him rooting around my chest. My gritted teeth turned to wailing and then soon to screaming as the doctor’s hands continued to work.
A nurse came over and smartly removed my son from my chest as my body had started writhing violently with the surges of pain. She wrapped the tiny blanket around him and handed him to his dad standing next to me. “He’ll come back to you soon,” she said reassuringly, gently squeezing my shoulder. But in my delirium, I barely registered him leaving me.
Why wouldn’t this end? It has to stop, I thought desperately. I began to wonder if this is what dying felt like.
As the fire in my body intensified and blood pooled beneath me, my mind started waving between the swirling lights and voices of people in the room and total blackness. In and out, in and out, until I started to wish just for the blackness.
By the time they started wheeling me to the operating room, the black stretches were far longer. But in one of the lucid moments in between I looked up at my doctor pleadingly and asked, “Am I going die?”
What I remember most about his response was that he paused before giving me one. “We’re going to take good care of you,” he said. Even in my state, I recognized the absence of a firm assurance. I might die, I thought to myself.
And then: At least it will make this stop.
I woke up a few minutes after surgery and began crying. I was sad having lost this time with my new baby, of course, but my tears were because, despite the procedure I’d just had, the pain felt continued to wrack my body. How could this be, I wondered?
I was told that they were giving me morphine, and that they’d almost reached the point where they couldn’t administer any more. They asked for my consent to keep going with the medicine and I nearly screamed my yes.
They handed me back my newborn son and I cradled him once again in my arms, but, once again, I couldn’t focus on him for the pain. “This isn’t right,” I told them. “It still hurts so badly.”
“It’s going to hurt for a while, hon,” I was told by the nurse. “Your body has been through a lot.”
I knew that was true, but just like before, it didn’t seem like this level of pain was normal or even survivable. I tried to explain this through my sobs, and the people around me started smoothing my hair and rubbing my arms in comfort.
“This can’t be right. It has to stop,” I started saying on repeat, tears rolling down my face.
The nurses looked at me with genuine sympathy as they adjusted my sheet and left me to nurse my new baby.
It was about a year later when I was reading over the data. I’d sent in my saliva the year before to learn more about my ancestry, but now this site promised me they could use that same data to give me intriguing health information.
So far I’d learned that I was at moderate risk of about eight thousand diseases and that I had a low sensitivity to caffeine, which explained why I seemed to be impervious to its effects. Then I started reading about being insensitive to something else.
I learned in that report that I was genetically a poor metabolizer of CYP2D6, an enzyme that converts pain medication into its active form in the body. The report said little more, but it was enough to start me researching.
What I learned is that this deficiency, which was far from rare, meant that pain medication like codeine or hydrocodone works much less effectively or barely at all. Those of us with this genetic make-up require far more of these drugs to get relief, if they ever provide any relief at all.
With my toddling one-year between my legs, I was transported back to the day of his birth, desperately pleading with the medical staff to understand the pain I was in. It wasn’t that they hadn’t cared that I was hurting, but they had normalized it. They’d offered me pat reassurances and wished me well. They didn’t – or couldn’t – imagine that the intensity of what I was describing was true.
Pain is notoriously hard to capture in words, its edges never quite reflected sharply enough. And while we assume that we as humans have a shared understanding of pain, the limits of our own experience mean we can never be sure.
But even with it’s slipperiness, there’s something else that it makes it hard to communicate your pain and be believed: being a woman.
The data is clear. Women’s pain is much less likely to be taken seriously and less likely to be treated as quickly or strongly. And it’s not just pain that occurs in the realm of childbirth or gynecology, where we might – over-generously – assume that the problem is male doctors who can’t relate. It’s all pain.
Take for example the fact that women who have chest pain and visit the emergency room will wait 29% longer than men before they are taken seriously enough to be evaluated for a heart attack. Or that women who show up with acute abdominal pain are 25% less likely to get strong pain medication than men. And even once women are evaluated for chest pain and other heart disease symptoms, they are twice as likely to be considered to have a mental illness.
Ascribing physical pain to emotional “weakness” is hardly new. Even the term “hysterical” derives from the Greek word hystera, which means uterus. The ancient Greeks and others believed that the unruliness of some women was a function of a wandering uterus, which they decided happened when the poor women in question did not have children to help stabilize it.
These (childless) hysterical women with their hysterical complaints were themselves considered a pain, for both doctors and society.
Perhaps it’s no surprise then that pain that women experience in the course of trying to have or trying to prevent having babies is among the least acknowledged in our medical system.
I can’t talk to a handful of friends who have had an IUD placed without at least several of them remarking on how brusquely their pain around it was dismissed. They were told to expect slight discomfort and were met with significant pain instead. For most, until they talked to others who experienced the same, they assumed they were an anomaly.
And then there’s the stomach-churning case of the women at the Yale fertility clinic who were undergoing egg retrievals in 2020 and had the fentanyl prescribed for anesthesia replaced with salt water by a nurse who was stealing the drug. Had the very first woman who complained that she felt like she was being stabbed been believed, the scandal could have been uncovered sooner. But instead, dozens and possibly hundreds of women faced the same torture. All because the pain they were reporting wasn’t taken seriously.
What happens when you experience intense physical pain but aren’t believed? Rather than rage against the deniers, most of us will look for alternative explanations, and most of those will turn the focus on ourselves.
We might consider that we’re more sensitive to pain than most patients or that we’re somehow getting it wrong. Maybe we didn’t understand what to expect. Maybe other people are just that much stronger than us.
Faced with a significant experience of this or with a lifetime of being told that we complain too much, we learn to stop talking about our pain at all. What’s the point when others won’t understand and won’t do anything to help?
Aside from the obvious injustice and human rights violation of making women suffer more, this is another of the insidious consequences of this problem. Not only do women experience unnecessary physical pain, but our sense of selves as strong, resilient people can start to wither. We start to question how capable we really are at withstanding difficult things. We doubt ourselves and the truth our bodies are telling us.
And that might be the most painful outcome of all.
Pain is hard to talk about, both semantically and emotionally, but it’s in the sharing of these kinds of stories that we help to address this problem. When we hear enough of the stories of women’s pain being dismissed, we start to see the challenge as out there rather than in here.
While we work to educate medical professionals and even the general public about gender bias in pain, women can help to advocate for themselves by not backing down when our pain is minimized or disregarded. It’s laborious to have to keep pushing back, keep “complaining,” keep asking for tests and medicine and answers, but it may be the only way that we get what we need.
If we find that our pain is dismissed by a particular provider, we can take our healthcare elsewhere. We can have someone we trust go with us to the ER or an appointment to help lend the credibility that we, of course, should already have.
What we can most importantly do, though, is to keep believing our bodies. Our pain is communicating something deeply important.. Whether others acknowledge it is irrelevant to its validity.