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Labor Pain

Updated: Mar 17, 2023


How painful is labor pain?

Every mother’s experience with pain during childbirth is different and personalized. What it means is that how you experience pain can be very different from your mother, or your sister. However, what you must remember is that the pain during childbirth can be managed either through medication or by holistic approaches such as massaging, breathing techniques, and visualization.


Labor pain
Labor pain

There is also an interesting way of looking at the experience of pain. The experience of labor pain varies for each woman based on how she associates with the pain!


When women interpret pain as productive and purposeful(purpose: the baby is ready to come out to the world, and your body is supporting the baby), it is associated with positive cognitions and emotions, and they are more likely to feel they can cope with the pain.


Alternatively, when women interpret pain as threatening, it is associated with negative cognitions and emotions and they tend to feel they need help from external methods of pain control. This does not mean women who associate pain positively won't need pain control! Positive associations can help in managing pain, and anytime a woman feels she needs support, it is highly recommended to support the mother as much as possible and support her in every way possible.


The social environment seems particularly important in shaping a woman’s pain experience by influencing her interpretation of the context of the pain, and in doing so can change its meaning. The circumstances and social environment are dynamic and can also change throughout labor. Social media, and movies, can play a huge role in imprinting an experience.


Let’s come to why there is pain during labor.

Your baby in the uterus is now getting ready to come out into the world. The baby has to pass through the cervix and come out through the vagina, and it starts with uterus contractions.


The uterus is a muscular organ that contracts powerfully to squeeze your baby out, and those contractions are the reason for your labor pain. Besides intense muscle tightening throughout your abdomen and, sometimes, your entire torso and pelvic area, you may feel pressure on your back, perineum, bladder, and bowels.


True Labor Contractions
True Labor Contractions

There is something known as Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and might start to occur from the fourth month of pregnancy. Braxton Hicks contractions can be described as tightening in the abdomen that comes and goes. They often come with a change of position and stop with rest.


True Labor contractions cause discomfort or a dull ache in your back and lower abdomen, along with pressure in the pelvis. Some women might also feel pain in their sides and thighs. Some women describe contractions as strong menstrual cramps, while others describe them as strong waves that feel like diarrhea cramps. In True labor, contractions continue, despite moving or changing positions.


Stages of labor

In general, there are 3 stages of labor


The early phase of labor pain

Your cervix dilates, or opens, 3 to 4 centimeters and begins to thin (efface). Typically, mild-to-moderate contractions last 30 to 60 seconds and can occur every five to 20 minutes, becoming stronger and occurring more frequently.


Early labor contractions will usually cause the abdomen to feel tight to the touch. You may also experience a dull backache, feelings of pressure in the abdomen and pelvis, and sensations similar to those of intense menstrual cramping.


Full dilation happens around 10 cms
Full dilation happens around 10 cms

The active stage of labor pain

Contractions continue to become longer, stronger, and closer together, and your cervix dilates to 7 centimeters. This is when most people request pain medication, though sometimes it's given earlier. (Remember, pain is very individual and there is never a "wrong" time to request pain medicine when you're in labor, so be sure to let your nurse know so they can help you stay as comfortable as possible.)


As labor progresses, contractions may feel like they are wrapping around your body from the back to the front. You may also begin to notice cramping and discomfort in your legs as the contractions become more frequent and last closer to 1 minute in length.


When you are approximately 8 centimeters dilated, you may have 30 seconds to 1 to 2 minutes between contractions as you prepare to enter the pushing stage of labor. During this time it’s not uncommon to feel lightheaded, nauseous, and have hot flashes or chills.



Pushing

When you are fully dilated (around 10 cm) and it’s time to push, you may feel an intense pressure that feels like you need to poop. You can relax a little knowing that your body is just telling you that it’s ready for you to help push out your baby.


During this period, you’ll typically be instructed to push with the peaks of your contractions. Because you are pushing with the contractions, many women find these contractions less painful than the contractions helping them to dilate.


Other parts of the experience may also cause discomfort or pain, including an episiotomy or vaginal tearing. You may also feel muscle pain or fatigue from pushing or experience uncomfortable side effects from medications used during labor.


After this stage for most people, the placenta is expelled easily in a short amount of time. If there are any complications during this stage, your healthcare team will help manage your pain as best as possible.


How to prepare yourself for labor pain?

Labor is an emotional experience and involves both physiological and psychological mechanisms. Though the pain of labor is severe, despite this its memory diminishes with time. Did you know effective management of labor pain plays a relatively minor role in a woman's satisfaction with childbirth?


During your pregnancy, you can -

Exercise regularly -

Regular exercise during pregnancy helps control your blood pressure, mood, and weight but also can help keep your body in shape for the work of labor. Join a prenatal class. Prenatal yoga classes usually consist of meditation too, and it can help you calm your mind during labor.


What you can do during pregnancy
What you can do during pregnancy

Attend a birthing class -

Knowing what lies ahead can help you relax and feel more comfortable during labor. By knowing the purpose of labor, the chances of you managing labor pain are high! Most birth preparation classes include instruction on comfort measures during labor, so you and your partner can get ideas and practice before the big event.


Take your prenatal vitamins -

It’s important to put the right nutrients in your body to help your baby grow properly and give yourself energy for labor.


Healthy and nutritious diet -

Along with exercise, you need good food for the body. Good food can help you keep your cravings in check too!


Lamaze philosophy & Bradley method

are some of the most common philosophies that are most commonly practiced in the U.S. in recent times, even in India Lamaze technique is taught by many Lamaze-trained birth educators.


During labor, you can try these tips -

As mentioned above, pain is individualistic and effective management of pain depends on various factors. You can choose any combination that relaxes you, and discuss it with your doctor or midwife.


Non - medical
Breathing techniques -

Whether you choose to follow a particular breathing routine during labor or just need to do some low vocalizations to help you through the more intense contractions, focusing on your breathing can help you manage the pain.


Diaphragmatic breathing can help manage pain during labor
Diaphragmatic breathing can help manage pain during labor

Use of water -

Even if you do not want to give birth in water, spending some time in a shower or bath can help relieve the pain of childbirth.


Being in the water has been found to be particularly effective in the first stage of labor. It can help relieve both pain and anxiety. If you have access to a moveable showerhead, aiming warm water directly onto the lower back may feel especially pleasant.


Massage and counterpressure

Many different types of massage can help manage pain during labor. Foot, hand, back, and shoulder rubs may all appeal to you. One study from 2010 found that a 15-minute massage each hour during labor helped alleviate pain and was even associated with shorter labor.


Additionally, perineal massage can help protect and prepare the perineum for the stretching involved in birthing a baby.


Massaging and Birth Plan can also help during labor
Massaging and Birth Plan can also help during labor

In addition to massage, many women enjoy pressure being strategically placed on parts of their body to help counteract the discomforts they may be feeling.


You can either ask your partner, midwife, or nurse to help you with the massaging.


Music -

Music can lower stress and blood pressure. It can also improve your mood! But can it really help with pain during labor? Yes, it does. A large meta-analysis found that music interventions helped alleviate pain and anxiety during labor.


Visualization or hypnosis

Guided imagery, hypnotic tracks, and other visuals can all help relax a mother in labor and relieve pain. You can plan to attend a Hypnobirthing class during your pregnancy. Visualization techniques are taught in birthing classes.


Movement

Walking, rocking on a birthing ball, or even slow dancing with your partner can help labor progress and relieve some of the discomforts you may be feeling.


Experimenting with different positions, including sitting, standing, or squatting, may also help reduce pain. Squatting offered the most pain reduction, but you can experiment with what feels best for you.




A TENS unit

Many people have found some pain relief during labor by stimulating their lower back with a transcutaneous electrical nerve stimulation (TENS) unit. (Some hospitals even have TENS devices that you can borrow during labor!)


Aromatherapy

If you are feeling nauseous or anxious, peppermint, lavender, or some citrus essential oils may provide some relief during labor.


Medications to manage pain

A variety of pain medicines can be used during labor and delivery, depending on the situation. Many women rely on such medicines, and it can be a huge relief when pain is quickly eased and energy can be focused on getting through the contractions. Talk to your healthcare provider about the risks and benefits of each type of medicine.


Analgesics.

Analgesics ease pain, but don't numb it completely. They don’t affect sensation or muscle movement. They can be given in many ways. If they are given intravenously (through an IV into a vein) or through a shot into a muscle, they can affect the whole body. These medicines can cause side effects in the mother, including drowsiness and nausea. They also can have effects on the baby.


Techniques to ease labor pain
Techniques to ease labor pain

Regional anesthesia.

This is what most women think of when they consider pain medicine during labor. By blocking the feeling from specific regions of the body, these methods can be used for pain relief in both vaginal and cesarean section deliveries.


Epidurals

a form of local anesthesia, relieves most of the pain from the entire body below the belly button, including the vaginal walls, during labor and delivery. An epidural involves medicine given by an anesthesiologist through a thin, tube-like catheter that's inserted in the woman's lower back. The amount of medicine can be increased or decreased according to a woman's needs.


Expert Tips
  • If you keep yourselves informed about labor procedures and management, you can expect more satisfactory your birth will be.

  • You have the right to decide for yourself and your baby. So participate and ASK.

  • You can ask the following questions to your care provider

B: Benefits of induction. (How would it benefit me and the baby?)

R: Risks (Are there any risks involved?)

A: Alternative. (Is there any alternative to start labor naturally?)

I: Intuition. (What is your gut telling you?)

N: Nothing. (What if we do nothing and wait?)

E: Emergency. (Is it an emergency?)

D: Decision. (Make the decision based on the above factors.)


Resources

Dealing with pain during childbirth


Labor pain explained: stages, symptoms, and pain relief


True vs. False labor


The pain of labor


Pregnancy and childbirth


How painful is childbirth?


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