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The Vaso Vegal reactions are due to a pain experienced in your body that is perceived by the brain to be too much for your body to handle so it shuts down. I have had episodes due to the pain of having endometriosis and giving birth. I had one instance where it did not seemed to be brough on by anything. The falling and hitting your head scenairo is not far fetched. It happened to me when I was 18 on a train platform. I woke up in the ER. When I had my child a year ago I knew I'd pass out and if I couldn't push then they'd have to give me a C-section. I am so afraid of that. But it may sound hokey but keeping calm and doing something meditative coaching yourself through it helps. I was not able to really participate in the birth of my first daughter and don't remember her coming out or any of the details. When I had my second meditating kepthelped me not to black out and was able to really experience it all. Epidurals are also necessary.