A few days before I gave birth to my eldest daughter, a friend had a heart-to-heart talk with me and told me after receiving the epidural, I should repeatedly hit the nurses' call button. "Be a nudnik, don't be embarrassed," were her exact words. In a low voice, like she was revealing a deep secret, she added, "the epidural doesn't always work, you know."

I didn't know. What was preoccupying me at the time was my future motherhood, my extremely swollen appearance and all the other ills of pregnancy. I had given almost no thought to the birth itself. The picture my imagination painted - which was based on books, my doctor and the stories told by friends - was that after I received the epidural, I would lie on my back and read a book until the baby emerged.

That was an illusion, of course. The epidural did not have the effect I had expected. My friend's advice was right, and could have reduced my pain. But I was fully cognizant of the lack of empathy shown by the nurse, who was about to finish her shift, so instead I conformed, and practiced noteworthy restraint.

Women tend to wistfully remember giving birth and to tell about it with a kind of exaltation. Like hunters in days gone by, who would sit around the fire and tell about their pursuit of a deer, women sitting around in a group always eventually get down to precise, detailed reports of their birthing experiences, in which they praise their heroic restraint, despite the pain and suffering, to the heavens ("I didn't let out a single moan").

This ethos is fostered by the prenatal preparation industry. The courses focus on how to deal with pain by breathing or through guided imaging. In short, by ignoring it. Nobody tells you, "scream until the sky falls in, like an animal, because it hurts." You prepare for childbirth as if it were the premier experience of your life. Nobody tells you about the behind-the-scenes humiliations, the complications, the failures, the deaths.

And this is true not only in childbirth. Because of the risks entailed in anesthesia, there are quite a few women who, when undergoing fertility treatments, agree to undergo invasive and painful treatments, such as extracting the unfertilized eggs or implanting the fertilized ones in the womb, while fully conscious. Most doctors do not dissuade them.

According to Ran Reznick's report in Haaretz, Dr. Galit Saada-Ophir, who died last Thursday at Hadassah University Hospital, Ein Karem, complained all night about "enormous pain." And I wonder whether this dry formulation merely indicates blindness and negligence on the part of doctors and nurses, or whether there is also an intolerable gap between the doctors' understanding and the actual level of the mother's pain and distress.

There is no doubt that Saada-Ophir complained. It is written in black and white in her medical file. But perhaps there is something in this culture of "suffer in silence," with which women cooperate, that causes doctors to make light of a matter-of-fact report of pain?

Pain is a symptom. A warning light. Perhaps, if doctors were educated to understand that when a woman says it hurts, it really hurts - that she is not screaming or turning over tables because she has self-respect, because she was educated to grit her teeth, but it nevertheless hurts - perhaps they would be quicker to anesthetize, to calm, to seek out the reason for the pain, and thereby even to save lives. But until then, sisters, scream. Don't be embarrassed.