Month 9: Put pain in its place

Describing the pain of labour is complicated, as it does not bear any similarity to anything you have ever felt before.

Labour is painful – even though it is a natural physiological process. While it has never been safer in terms of survival of mother and infant to have a baby, the medicalisation of labour, which is in part responsible for the improved outcome for women, may now also be making labour more painful, as normal birth without obstetric intervention becomes increasingly rare.

It’s possible to have labour with relatively little pain, but it’s wise to prepare yourself by planning some strategies for coping with pain. Planning for pain is one of the best ways to ensure that you’ll stay calm and be able to deal with it when the time comes.

Pain in labour has a predictable pattern and is associated with contractions of the uterus. The location of the pain during labour will change constantly

– in duration, intensity and frequency. Pain during labour is different for every woman. Although labour is often thought of as one of the more painful events in human experience, it ranges widely from woman to woman and even from pregnancy to pregnancy.

It’s often not the pain of each contraction on its own that women find the hardest, but the fact that the contractions keep coming – and as labour progresses, there is less and less time between contractions to relax.

Pain during labour is caused by contractions of the muscles of the uterus and by pressure on the cervix. This pain may be felt as strong cramping in the abdomen, groin, and back. Some women experience pain in their sides or thighs as well.

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 works. 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 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.

The physical and emotional challenge and stress of labour can cause great fatigue, which will make the mother feel more vulnerable and sensitive to pain.

A full bladder can increase pain.

Dehydration is a big cause of pain.

Hunger increases pain perception.

Feelings of being observed or feeling unsafe also enhance the feelings of labour pain.

Other factors that cause pain to be magnified are fear, tension, incorrect positioning and lack of knowledge about the process.

PREPARING FOR PAIN

To help with pain during labour, here are some things you can start doing before or during your pregnancy.

Regular and appropriate exercise will help strengthen your muscles and prepare your body for the stress of labour. Exercise also increases your endurance and stamina, which will come in handy if you have a long labour. The important thing to remember with any exercise is not to overdo it – especially if you’re pregnant. You and your partner should attend childbirth classes and become informed of the process. This way you will learn to work with your body and not against it, and you will learn different techniques for handling pain. Remember, birth is a normal, natural, and healthy process, and you should be empowered to approach it with confidence.

Classes educate you about the ways you can decrease their perception of pain, such as through relaxation techniques, breathing exercises, distraction, or massage and acupressure by a supportive or significant other.

Practise perineal massage and do pelvic floor exercises. The perineum stretches dramatically during birth, so getting it supple and stretchy before labour day is a good idea. You will slowly start to build up a tolerance to the feeling of the stretching sensation of perineal massage, long before your baby stretches the perineum as she slips out. Pelvic floor exercises will strengthen the area, which means it will stretch easier.