Childbirth and the Measurement of Pain

Recently, one of the writers in my writing group shared from her novel a childbirth scene that takes place in the early twentieth century. Given the lack of advanced medical facilities in this setting, the character in question – the woman in labor – is described as experiencing a great amount of pain. As anyone who has ever attempted to write a piece of narrative knows, describing physical sensations like pain is often the most difficult part, because it goes through two levels of subjectivity – the author’s understanding of the kind of pain being described, and the reader’s experience of it. Obviously, one of the main points of discussion among the group that day was whether or not the pain of childbirth had been appropriately described in the scene. Unfortunately, this discussion eventually devolved into an argument between a few women, about how much pain and discomfort they had experienced during the births of their respective children. While one of them claimed to have had a zen-like experience that is the ultimate Scientology dream, another waxed eloquent about the brutality of pushing a mini-human being into the world. It was morbidly interesting, this discussion, even if totally off-point, and only for a while.

I came home and reported the happenings of the day to Boyfriend, and when I came to the childbirth story, I could see his interest pique. (Seriously, if he were a dog, his ears would have stood up.)

“How come you’re so interested in pain during childbirth?” I asked, in expectation of a bit of mostly useless but utterly juicy information. (Seriously, if I were a dog, I’d act like I had just smelled a treat.)

“Did you know,” he began, never one to disappoint. “In the 1940s a bunch of scientists decided to measure pain objectively, using what they called the Dolorimeter, and their experiments involved subjecting women’s skin to burning, while these women were giving birth?”

"They wanted to do what?" (Image source.)

“They did what?” (Image source.)

It was, to put it simply, a massive scientific boo boo.

In 1940 James Hardy, Harold Wolff, and Helen Goodell, all scientists from Cornell University, set out to devise an objective scale along which pain could be measured. They first agreed upon a unit of measurement: dol, after dolor, the Latin word for pain. Then they created a scale measuring 0 dols – 10.5 dols, with each half of a dol signifying a “just discernible” change in pain.

Obviously, these scientists needed subjects on whom to test this out. Initially, they found four volunteers, who they subjected to hundreds of painful experiences of varying degrees, each using a different torture device. Sometimes, tiny portions of their skin were burned. Sometimes they had sharp objects poked into their flesh. Sometimes they were swatted with blunt objects. I mean, throw a whip and a pair of handcuffs in there, and you’d have yourself an elaborate S&M fantasy.

Following the results obtained from these initial experiments, the scientists recruited a bunch of medical students, who then proceeded to inflict torture upon one another, primarily by burning blackened parts of each other’s foreheads and arms and hands. This second round of experiments, while boosting the validity of the data, was still not enough to establish an objective measurement of pain.

So the scientists decided to launch into a third phase, where they would find the worst possible pain any human being could ever go through, and use that as a 10.5 on the Dolorimeter, thus enabling measurement of lesser pains against it. And what was this worst possible pain? Think about it. If 0 is when you’re sleeping calmly in your tempur pedic bed, dreaming of unicorns and bunnies and a land made of cake and ice cream, 10.5 has got to be the opposite – when you’re lying splayed on a cold, metal table, hallucinating from the heat coursing through your body, swathed in the moisture that’s draining from your soul and pushing through the pores of your skin in the form of sweat. No, not the fires of purgatory. I’m talking about childbirth.

In 1951 Hardy, Wolff, and Goodell found nineteen volunteers to participate in their newest experiment, in which they would expose four different spots on the volunteers’ arms as they went into labor, and were between contractions. And yes, while they were in labor and between contractions, these women would also have to respond to the scientists’ questions about how the most recent burn compared to the pain of their contraction.

As to who these women of Amazonian temperament were who volunteered for this experiment, I know not. (But as the Showtime series Masters of Sex tells us, in the 1940s and 1950s, you could make people do about anything in the name of science.) Hardy, Wolff, and Goodell did hit a roadblock with some of them, though. You see, while most of these nineteen women were cooperative enough to allow their arms to be burned during childbirth, legend has it that one of them gave the experiment a royal fuck over with her gargantuan tolerance of pain. Hardy et. al. continued subjecting her skin to heat until it started to blister, and she still claimed that the pain this was causing her was nowhere near the pain of her contractions. (Okay, maybe she didn’t have gargantuan tolerance of pain, maybe she was just giving birth to a giant baby.) Then there were a couple of others, who, the researchers reported in their paper, “became so hostile that attempts at further measurements were abandoned… this failure to obtain valid measurements was due mainly to an unwillingness on the part of the patient to cooperate,” because these volunteers just didn’t understand the “necessity of feeling the pain twice.”

It was truly dishonorable on the part of these women. Hardy, Wolff, and Goodell had sacrificed more than a decade of their lives to the meticulous torture of people, only to have some weak-willed women come and ruin it all. I mean, come on. If a bunch of medical students was willing to walk around the hallways of a hospital with second degree burns on their foreheads, why couldn’t these women put up with having their arms burned in four spots? Because they simultaneously had a freakin’ human being tearing through their blessed ring-dang-doo? Oh, please. Grow up. (And breathe. Breathe. Breathe.)

Unfortunately for Hardy, Wolff, and Goodell, their work was discredited in part and in whole by various scientists in the following decades. Soon after the experiment with the women in labor, a group of anesthetists got together and tested the Dolorimeter, by putting themselves through over a hundred hours of painful experiments that sometimes took a long time to heal. (What is with these mid-century doctors burning each other?!) They concluded that while it was an effective tool for evaluating the efficacy of analgesics, it didn’t work all that well in measuring pain. Henry Beecher, Chair of the Department of Anesthesia at Mass. General, was one of the greatest critics of the Dolorimeter, insisting on a system that takes into account subjective tolerance as well as the complex emotional structures underlying physical pain. In the 1970s, Ronald Melzack and Warren Torgerson attempted to create a language of pain, again trying to incorporate unique, individual experience into their understanding of it.

So I guess all those people back in the ’40s and ’50s suffered focused second degree burns for nothing. If the Dolorimeter had been successful, at least the women who put up with the torture while pushing their child into being would have had an amazing story to tell. As it stands now, the legend of the Dolorimeter starts out like a TV sitcom that has promise, but devolves very quickly into a series of shows and movies that do little other than inflict pain. Quite like the video below.

Want to know more? Go here. And here.

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One thought on “Childbirth and the Measurement of Pain

  1. Pingback: Three Teaspoons of Vaseline A Day Keeps the Doctor Away? | Stuff My Boyfriend Tells Me

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