Painful. Excruciating. Unbearable. These are the words most often associated with childbirth.
But what about pleasurable? Blissful? Euphoric?
Some women even say that instead of agony, childbirth can be ecstasy.
Amber Hartnell of Hawaii said she experienced an orgasm during labor when she gave birth to her son in September 2005.
"All of a sudden the orgasm just started rolling through and rolling through, and it just kept coming, and my whole body was spiraling and rolling, and I was laughing and crying," she said.
Hard to imagine? Hartnell and her husband, Nassim Haramein, were shocked as well. Although they had spent many hours planning for their son's birth, in a tub under a tree outside their home, they say they never planned for an "orgasmic" birth.
Haramein was amazed -- and also relieved -- to see his wife experience such pleasure.
"It made me feel like everything was gonna be all right," he said. "The experience didn't have to be a traumatic, painful experience. It could be an experience of ecstatic joy."
"It is, as we say, the best-kept secret," said Debra Pascali-Bonaro, a childbirth educator for 26 years. "I believe by women having such terrible fear. … Women aren't getting the choices they need, to make the experience as easy as possible."
To prove that it is possible to have pleasure in childbirth, Pascali-Bonaro made a documentary called "Orgasmic Birth."
Tamra and Simon Larter of suburban New Jersey were one of the couples that allowed Pascali-Bonaro to film their most intimate moments of labor. For their second child, the Larters wanted a natural birth with midwives at their home. They spent part of Tamra Larter's labor kissing and caressing.
"The physical touch and the nurturing was just really comforting to me," Tamra Larter said, adding that she ultimately experienced an orgasmic birth. "It was happening, and I could hardly breathe, and it was like, 'oh, that feels good.' That's all I could say really."
Dr. Christiane Northrup, a board-certified OB-GYN and author of "Women's Bodies, Women's Wisdom" and "Mother-Daughter Wisdom," said orgasms during labor are caused by basic science.
"When the baby's coming down the birth canal, remember, it's going through the exact same positions as something going in, the penis going into the vagina, to cause an orgasm," Northrup said. "And labor itself is associated with a huge hormonal change in the body, way more prolactin, way more oxytocin, way more beta-endorphins -- these are the molecules of ecstasy."
Northrup says that women's expectations can have a large effect on how pain is perceived.
"Whenever you expect pain, you tense up your muscles, your stress hormone levels go up and that increases pain," she said.
Pascali-Bonaro said that one of the missions of her documentary is to show how the hospital experience should be improved to help decrease pain for laboring women.
"If we look at most other countries in the world, women have a lot of options. They're allowed to be upright, they can move in labor. They can use warm water. They can use balls. There's so much that they can do that makes the experience easier," she said. "In the U.S. today, you walk in a typical hospital, you're put in bed on your back. That in itself makes labor longer and harder and more painful."
Joining in this message are women like Karen Brody, a playwright who wants women to make empowered choices about their birth experiences.
As part of her organization Birth on Labor Day, or BOLD, she developed a play called "Birth," performed in communities to spread the message about new options in childbirth.
Kimberly Baker, a mother from Memphis, Tenn., directed and acted in one of the "Birth" productions, portraying a woman who ultimately experienced an orgasmic birth.
"Unless you've met somebody who's had a positive, natural birth experience, and you've heard them tell the truth about their experience, then all you have is the unknown," she said.
To actually experience an orgasmic, or pleasurable birth, Northrup says it's important for women to lose their fear and their inhibitions. One method is to practice relaxation techniques. For Hartnell, chanting and doing yoga helped transform the pain into what she calls simply "sensations."
Another key element is not to block those sensations with anesthesia -- a prospect that is not pleasing to the many women who rely on modern medicine to avoid intense suffering during childbirth.
"The process of labor is there for a reason," Northrup said. "It is part of the human experience to experience pain, the other side of which is this incredible ecstasy."
Claudia Montes, a New Jersey mother of three, was determined to experience that ecstasy.
After giving birth to her first two children with an epidural, she wanted to have what she calls a "pleasurable birth" at the hospital, without pain medication. But her toughest obstacle turned out to be her husband.
"I don't understand choosing pain over, you know, modern medicine where you could be blissed out artificially," said her husband, Jay Edlin.
Montes disagreed, saying, "The whole thing is he didn't want me to suffer. And my whole thing is, you know, suffering is perceived."
Montes hired a midwife instead of a doctor and practiced hypnosis for months in order to relax for labor. Her hard work paid off.
"I didn't feel pain," she said. "I was in bliss, because I felt safe, because I felt empowered."
Even her husband agreed she chose the right path.
"She ultimately was right and I was wrong. I never envisioned that, you know, it would have such a happy ending," he said.
For women who hope to create a similarly happy ending for their labor, Pascali-Bonaro hopes they realize that it's possible, but the goal is not necessarily an actual orgasm.
"I hope women watching and men watching don't feel that what we're saying is, every woman should have an orgasmic birth," she said. "Our message is that women can journey through labor and birth in all different ways. And there are a lot more options out there, to make this a positive and pleasurable experience."