BirthTruths: The Truth About Pain

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All women have a pool of knowledge, beliefs, and ideas around childbirth that come from a variety of sources. We consciously or subconsciously receive messages from the media, entertainment, our family, friends, and peers, and from the collective memory of the women around us, and those messages influence our own thoughts and feelings about giving birth. Within this pool of knowledge, the fact that childbirth is painful is often at the forefront.

Barriers

Many women express a desire to have a “natural” birth. The definition can vary woman to woman, but often what is meant is an unmedicated, vaginal birth.

A lack of realistic expectations about pain in birth and about the determination required of you to move through labor without pain medication can create a barrier to achieving this desire. As can a lack of knowledge of your own capabilities, a lack of a confident and supportive birth team, a lack of physical and emotional preparation, and a lack of effective coping measures during labor. But those are posts for another day.

So if you’re hoping for an unmedicated birth or if you’re just thinking about it and you’re wondering what to expect in the pain department, read on.

#1 The pain of birth is normal and purposeful. It’s normal because bringing a baby into the world is intensely hard work for your body, along with your mind and heart. It’s hard like running a marathon is hard or like completing a thesis is hard or like facing great uncertainty is hard. But every contraction brings your baby closer, and pain is just a sign that your body is doing that hard work.

#2 The pain of birth is really intense and legitimately one of the hardest things you’ll probably ever do. Though some women experience painless birth, that is not the norm. There will be times when you will want to give up, and that’s totally normal. Overcoming the painful and overwhelmingly difficult parts of labor will require determination, endurance, and courage from you.

#3 The pain of birth is temporary. It may feel overwhelming and never-ending, but taking labor moment by moment instead of thinking about how long it might last can help it feel less so. In the grand scheme of things, the pain of labor is relatively brief. It won’t last forever. You can do anything for five minutes. And then you can do it again.

#4 Your perception of the pain of birth is dramatically influenced by your hormones and emotions. The physical pain of labor is real, but feeling helpless, afraid, unsafe, or stressed can drastically intensify those feelings. Feeling fearful inhibits the helpful hormones of labor and increases pain. Feeling safe, supported, and respected helps your body produce the oxytocin and endorphins that help reduce pain and make labor effective.

#5 Most women will experience parts of labor as not painful. Usually there is a break between contractions that may be uncomfortable but not painful. Those breaks will give you a chance to catch your breath and perhaps rest a little.

Note: There are some factors that can reduce those breaks, such as having a posterior baby or being on synthetic oxytocin. Having back pain in between contractions with a posterior baby is not unusual, but it’s rarely as intense as contractions. Leaning forward over a bed, counter, or exercise ball can help your posterior baby turn and take the pressure of your back.

If you are on synthetic oxytocin (Pitocin) to induce labor or speed it up, your contractions may be longer, stronger, and closer together with little break in between. You may be able to have the Pitocin turned down, and if you want an unmedicated birth, you may want to consider avoiding induction and augmentation altogether if there is no medical indication.

#6 The harder it gets, usually the closer you are to giving birth. When those breaks do start getting shorter or disappearing completely, you are probably getting really close to pushing. During transition (the last phase of active labor and final few centimeters of dilation before pushing) you may feel like you simply can’t do it even if you’ve been coping really well up until that point. You may cry, feel overwhelmed, and be ready to throw in the towel. Be prepared for this. Some women feel the emotions of transition as they go from early labor to active labor as well. This is all a very normal part of the process and can be seen as an encouragement that you are going to meet your baby soon!

#7 Sometimes the pain of birth is unusually difficult. There is such a thing as an unusually painful labor, and there is a difference between pain and suffering. There are times when pharmacological pain management is absolutely the best thing for a mother and helps to facilitate a safe and satisfying birth. It’s ok to want and plan on medical pain relief. And if you were hoping and preparing for an unmedicated birth and end up needing or wanting medical pain relief, it’s ok to be disappointed. It’s also ok to feel happy and at peace with your choice. To face choices and circumstances in birth that you had hoped to avoid takes its own kind of courage and endurance.

I want to hear about your experience! Was the pain of labor what you expected? Let me know in the comments!

Recommended Resources

Pain Medications Preference Scale by Penny SimkinThis tool is great for helping a woman think about her pain medication preferences during labor and communicating about them with her birth team.

Pain Management Series from Evidence Based Birth This podcast series is full of great information about scientific research on various aspects of pain and pain management during labor.

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