What is Childbirth Pain Like?
Childbirth is no different. For a few it will be relatively quick, straightforward and require little more than water to relieve the pain, if at all. For the majority it will last for around 12 to 24hours and start with a gentle introduction to the sensation of the contractions. As labour progresses and the contractions become more frequent the sensation of them becomes different. But this is not pain in the traditional sense. It is not a warning of impending danger or a nudge to seek medical advice. This time of your life is an awakening and, like being roused from sleep your body takes on a new meaning. It has grown and nourished a baby ready to be born and now is working to help you to give birth. This is not an illness or a warning of disease or something you need to be saved from. This is a journey and the contractions that your body is having should be seen as that.
What is a ‘Contraction’?
The word ‘contraction’ is a medical term used to describe exactly what the muscles in your uterus are doing. But labour and birth are so much more refined than that and to talk of the process of your baby being born in such simplistic medical terms is to do it an injustice. These are ‘contractions’ or ‘rushes’, as your body awakens to a new role and, with each contraction your body and your baby work in harmony. Contractions themselves are not painful.
The act of the muscles in your uterus contracting and shortening to push your baby out is the same as any muscle when worked hard and it causes pain until you stop using that muscle because of the build-up of lactic acid. When we exercise or train hard our muscles will become sore due to a lack of oxygen. If necessary, we can stop and allow that pain to settle or we can push ourselves knowing that there is a benefit to this short lived pain. This is pain like any other muscle that is working hard but because it is exercise we accept that we can stop and recover if we need to. That is the natural effect of exercise. We do not decide beforehand to take pain relief in order to train harder, we embrace it. We embrace the good that it does, the way it makes us feel but most of all, we do not fear it.
Why Do We See Childbirth Pain Differently?
Why then do we treat labour so differently? Is it because we are in that situation for longer; but what of ‘ultra-runners’ and ‘Iron Men’? They will push their bodies for over 24 hours, how do they manage it? The answer is that they are mentally prepared. They accept that there will be pain that they will cope with it and find a way of ignoring it but they do not fear it.
That is how you should approach labour. You will not be ‘having’ contractions, they will be contractions of your uterus that bring your baby closer to you. The pain that you may have is just the muscles of your uterus contracting and they do this for 60 seconds on average. With each contraction you will focus on your breathing, aware that when the contraction stops the pain will cease. You are in control, this is your body and you are not a passenger. Like exercise you are asking your body to work hard for one minute and then rest, there is nothing to fear.
And essentially that is it, your body will very rarely have you in more pain than you can cope with otherwise you would be incapable of exercise or functioning through your period. You may find that you would like something to ease it and that is usually due to society and the medical profession making us believe that we need pain relief for child birth. If we are told something often enough we tend to believe it.
Pain is a very personal thing, no one will be able to understand the type of pain you have and how it makes you feel. This is true of all pain, whether you have broken your leg or are in labour. The difference with pain in childbirth is that it has a slow build up which allows your body to produce its own pain killers to help you cope. To fully understand why we have this pain we need to understand what causes it and why.
Our Pain Nerves
There are three types of nerves in our bodies, motor, sensory and a mix of motor and sensory. The nerves that give us our perception of pain in labour are sensory nerves and they are found throughout our bodies. It is these nerves that pick up all the information from our uterus, our back and down through the birth canal. When doing any type of physical activity your muscles become sore and you take a rest. Muscles become sore because not enough oxygen is getting to them. If you practiced this same exercise, over time your body would become more efficient at delivering more oxygen to these muscles and you could work for longer before you felt the same pain.
Your uterus is no different. It is a large muscle, working extremely hard for days, not just hours or minutes so it stands to reason that you would experience pain from this. With any other muscle you would have stopped using it to rest it or trained your body over time to provide it with extra oxygen to work longer. With your uterus this is not possible but you can use relaxation exercises to increase the amount of oxygen that you take into your body with each breath.
What Can Help?
I want you to imagine that you are in pain now, what does your breathing do? It speeds up and becomes shallow, limiting the amount of oxygen you take in. When you are in labour the pain is caused due to lack of oxygen to the uterus and is similar to the pain people experience during heart attacks. With a heart attack extra oxygen is given via a face mask, in labour you can simply use the breathing and relaxation exercises discussed previously. These exercises need to be reinforced by your birth partner constantly talking you through your breathing.
The other perception of pain you may have are the muscles of your birth canal and cervix stretching to accommodate your baby. Again breathing exercises will help with this type of pain but so will supporting yourself in water. Water is amazing for pain relief, the warmth relaxes and soothes muscles and the buoyancy ensures that the large leg muscles aren’t using up too much of your body’s oxygen. Just make sure the water is no hotter than 37 degrees centigrade otherwise the heat may cause your body to unnecessarily divert blood to your hands and feet and less to your uterus. Also, the back pain you may experience in labour may be soothed with water and breathing exercises.
For those of you experiencing a back to back labour you may experience more intense back pain rather than stomach pain and in this case it is caused by the pressure of your baby’s head stretching your spine and its ligaments. The simplest way to combat this type of pain is through back massage; your partner can help here. Back rubs are very effective at relieving the severe backache associated with some positions your baby may be in. If you imagine that your baby is trying to make more room in your pelvis then it stands to reason that the bones in your pelvis that can move will move. It is the stretching of the ligaments and muscles of this bone that cause the pain. Your partner’s back rub will help to take some of the pressure off and don’t worry; it will not harm your baby.
Here’s how to do it:
Back Rub
- Sit down facing the back of a chair and lean forwards.
- Just above the crease of your bottom your partner will see a diamond shape.
- Ask them to put their thumbs either side of the diamond.
- When you have a contraction ask your partner to press firmly with both thumbs until the contraction has stopped.
- They can also use the heel of their hand on the same area.
- Occasionally women find it increases their pain. If this happens ask your partner to stop and use a heat pack or hot water bottle instead.
You also have the option of using a Transcutaneous Electrical Nerve Stimulation (TENS) machine. It works by interfering with the pain message from the sensory nerves through your spine to your brain. TENS creates a warm, buzzy sensation on your back and you can safely use it at any time in your pregnancy and labour - just remember to remove it before getting into the bath.
There is an old midwives’ and nurses’ saying that ‘pain is what the patient says it is’; in other words, if you can feel pain and need pain relief, no matter what stage of labour you are in your midwife will accept that and provide you with what you need. However, that maxim can be a problem. As midwives we have spent years ensuring women receive pain relief when they want it, regardless of the stage of labour they are in. If you come into hospital in the early stages of labour complaining of pain your midwife may offer you strong pain relief that you cannot get at home, in the mistaken belief that you have already exhausted milder forms of pain relief.
On the other hand, if, after many hours of contractions you are no longer coping at home, do not shy away from calling the hospital and midwife and requesting pain relief.
