PAIN you can handle

Understand the purpose of labour pain and how you can successfully manage your own, writes Tina Otte

MOST PREGNANT WOMEN are so fearful of labour pain that they don’t even want to attempt natural birth. This fear is a huge impediment, both physically and mentally, to a positive birth experience.

We live in a culture that is afraid of pain and does not understand that there are many ways to manage discomfort, especially during labour. Many women do not know that they have built-in mechanisms that help them deal with the pain of labour. Their confidence is then further eroded by others telling them that labour pain is something to be avoided at all costs.

In many cultures, the pain of labour is seen as normal and valuable, but more often today, some women see labour pain as unnecessary and unwanted – not understanding that it has a very specific purpose. Describing the pain of labour is complicated, as it does not bear any similarity to anything you have felt before. Also pain perception in each person is unique.

Many factors will influence how you will experience labour pain, including your environment, your energy levels, your emotional state as well as the people around you and their attitude to pain. Pain may feel worse if you are very anxious.

WHY DOES LABOUR HURT?

Pain in normal labour does not mean that something is wrong. But why then is labour painful? Because giving birth demands the cooperation and hard work of many parts of the body.

The pain during labour will change constantly – in location, duration, intensity and frequency.

Pain in labour is associated with contractions of the uterus. The uterus and cervix have nerves that are sensitive to stretching and to lack of oxygen. The process of labour involves the stretching and opening of the cervix, which is the lower part of the uterus. The strong uterine contractions often cause pain sensations that may radiate into the thighs and around the back. During a contraction there is a temporary lack of oxygen, which causes the nerve endings to become very agitated. This is one of the reasons why breathing helps labour pain. Pain is decreased as you keep the working muscles oxygenated.

The pelvic floor muscles and perineum also contain many nerve endings and pain receptors. When

SOME WOMEN SEE LABOUR PAIN AS UNNECESSARY AND UNWANTED – NOT UNDERSTANDING THAT IT HAS A VERY SPECIFIC PURPOSE

stimulated by contractions, they send messages via your spinal cord to your brain, which registers as pain. The weight of the baby on the uterus, lower back, sacrum and tailbone is also a cause for pain.

This area of the body contains many nerves, and when pressure is applied, it can be painful – producing a sharp or dull backache. As the baby moves down the birth canal, there will be a lot of rectal pressure. Close to delivery, the vagina and the vaginal opening stretch to capacity, and this causes a burning or stretching sensation.

Hunger, dehydration and even a full bladder can increase pain perception during labour. Incorrect positioning, tension and lack of the understanding of the process can also heighten pain. Another thing known to heighten pain is fear itself.

HANDLING PAIN

Pain threshold is the level at which we recognise that we have pain. It is the point at which a stimulus, usually one associated with pressure or temperature, activates pain receptors and produces a sensation of pain. Individuals with low pain thresholds experience pain much sooner and faster than those with higher thresholds. One cannot alter the pain threshold with comfort measures. The location where we feel pain and how soon we feel it, stays the same.

Pain tolerance is the maximum level of pain that a person is able to tolerate. It is the level where pain can no longer be tolerated. Pain tolerance is distinct from pain threshold (the point at which pain begins to be felt). The good news it that you can alter your pain tolerance level with comfort measures (water, aromatherapy, breathing) or pain relief.

PAIN WITH A PURPOSE

Labour is not about pain and suffering, but rather pain with purpose – a means to an end. Pointless pain is more difficult to endure. Remind yourself that labour pain is a constructive, healthy pain, and it is part of a natural process. The contractions of labour signal for you to get to a place of safety and get ready for labour. The discomfort of labour is also a message for you to get moving, which in turn helps the pain. And in the end, it brings your baby to you.

Labour pain is not constant – it comes and goes and gives you lots of time to rest. During the restful stages, there is no pain, and you are flooded with hormones to make the process more manageable. This pain also stops once the baby is born and brings you your greatest gift.