Pain in Labor

Bring up the subject of pain in childbirth in a room full of women, and you’ll start a conversation that could go on for hours. Everyone has something to say on this topic—even people who never experienced labor themselves have a story to tell about their sister’s or friend’s experience with pain.

Women are given very mixed messages about pain in childbirth. They are told it will be tremendously painful and that you need to use drugs to control the pain. They are also told that pain is all in the mind, and that they should be able to control the amount of pain they feel.

Here’s the truth: labor is usually painful. Studies have shown that pain is registered the same by everyone. If you subject a wide variety of people to a pinprick, they will all physiologically feel the same amount of pain. What varies is how each person decides, consciously and unconsciously, to respond to it. The ability to respond less intensely to painful stimuli makes it feel like less pain.

The level of perceived pain is also affected by factors that are not necessarily under the control of the woman in labor. These factors include the baby’s position, the labor environment, who is with her during labor, whether or not she has given birth before, and how tired she is.

Why Does Labor Hurt?
Try squeezing a muscle in your calf or arm very tightly and holding it there for some time. After a while, it will begin to hurt, and maybe even cramp up. During labor, the uterus begins to squeeze very tightly, more than it ever has before, in order to move the baby down toward the birth canal.

Contractions of the uterus come in waves. In the beginning of labor, they are further apart and shorter in duration. As labor progresses, they go on longer, and there is less time between them.

Labor generally begins as a mild tightening, slowly building up in strength and intensifying to an almost tingling, burning sensation. Some women liken the pain of uterine contractions to strong menstrual cramps. Others say it feels like an incredibly powerful elastic band is squeezing their lower abdomens.

As labor progresses, the cervix begins to open up so that the baby will be able to pass through, and that causes new sensations. It can feel sharper and lower than the initial contractions. You may begin to feel pressure on the cervix, pelvic joints, and vagina. This pressure can feel almost needle-like.

Sometimes babies are not curled up in the neat balls that make for easier births. Their heads, instead of being tucked in, can press into the small of the mother’s back. This is known as back labor.

Another type of sensation is the stretching of the vulva in the final stages of labor, when the baby is passing through it. If you take your fingers and try to stretch your mouth open as wide as it can go, and then just a bit beyond that, you can get an idea of how that can feel. There is a stretching, burning quality to this type of pain.

The question is: how do you handle pain? We will look at both pain medication and natural ways of dealing with pain in labor. But, first, it is important to know that women do not need to have pain completely eliminated in order to report satisfaction with the birth experience. The pain of childbirth is not like the pain of injury, because it has a purpose and is productive.

Of course, women also don’t want pain to overwhelm and incapacitate them, and many are afraid that this will happen. Women receive little in the way of cultural messages that reassure them. Our culture teaches us to be fearful of losing control, and birth is a big unknown for most women.

Preparing yourself with an arsenal of nondrug pain-relief techniques can empower you and boost your courage as you approach the upcoming delivery.

Today’s Pain Medications: There are two major techniques used for women seeking drugs for pain relief during labor: narcotic analgesics and epidural anesthetics.

Narcotic Analgesics reduce pain and promote sleep. The most commonly used narcotic pain relief is Demerol. Other choices include Nubain and Stadol. Sometimes another drug, know as an antagonist, is added to the narcotic to decrease some of its negative side effects (such as nausea and dizziness).

While they do not completely alleviate pain, narcotics can either reduce pain or make it seem more tolerable by virtue of their relaxation effect. They are sometimes also used to lower high blood pressure during labor.

Narcotic pain relief is administered either by an intramuscular injection (usually in the buttocks) or via an intravenous (IV) line. It is best to avoid taking these drugs in very early labor, when they can slow things down.