Learning all you can about labor and delivery is
one of the best ways to help you manage the pain of childbirth when the time comes.
Pain During Labor and Delivery
Pain during labor
is caused by contractions of the muscles of the uterus and by pressure on the cervix.
This pain can be felt as strong cramping in the abdomen, groin, and back, as well
as an achy feeling. Some women experience pain in their sides or thighs as well.
Other causes of pain during labor include pressure on the bladder and bowels by
the baby's head and the stretching of the birth canal and vagina.
Pain during labor is different for every woman. It varies widely from woman to
woman and even from pregnancy to pregnancy. Women experience labor pain differently
— for some, it resembles menstrual cramps; for others, severe pressure; and
for others, extremely strong waves that feel like diarrheal cramps.
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 that as labor progresses,
there is less and less time between contractions to relax.
To help with pain during labor, here are some things you can start doing before
or during your pregnancy:
Regular and reasonable exercise
(that your doctor says is OK) can help strengthen your muscles and prepare your body
for the stress of labor. Exercise also can increase your endurance, which will come
in handy if you have a long labor. The important thing to remember with any exercise
is not to overdo it — and this is especially true if you're pregnant. Talk to
your doctor about what he or she considers to be a safe exercise plan for you.
If you and your partner attend childbirth classes, you'll learn different techniques
for handling pain, from visualization to stretches designed to strengthen the muscles
that support your uterus. The two most common childbirth philosophies in the United
States are the Lamaze technique and the Bradley method.
The Lamaze technique is the most widely used method in the United
States. The Lamaze philosophy teaches that birth is a normal, natural, and healthy
process and that women should be empowered to approach it with confidence. Lamaze
classes educate women about the ways they can decrease their perception of pain, such
as through relaxation techniques, breathing exercises, distraction, or massage by
a supportive coach. Lamaze takes a neutral position toward pain medicine, encouraging
women to make an informed decision about whether it's right for them.
The Bradley method (also called Husband-Coached Birth) emphasizes
a natural approach to birth and the active participation of the baby's father as birth
coach. A major goal of this method is the avoidance of medicines unless absolutely
necessary. The Bradley method also focuses on good nutrition and exercise during pregnancy
and relaxation and deep-breathing techniques as a method of coping with labor. Although
the Bradley method advocates a medicine-free birth experience, the classes do discuss unexpected
complications or situations, like emergency cesarean sections.
Medicine-free ways to handle pain during labor include:
massage or counterpressure
taking a bath or shower
listening to music
distracting yourself by counting or performing an activity that keeps your mind
A variety of pain medicines can be used during labor and delivery, depending on
the situation. Many women rely on such medicines, and it can be a huge relief when
pain is quickly eased and energy can be focused on getting through the contractions.
Talk to your health care provider about the risks and benefits of each type of medicine.
Analgesics. Analgesics ease pain, but don't numb it completely.
They don’t affect sensation or muscle movement. They can be given many ways.
If they are given intravenously (through an IV into a vein) or through a shot into
a muscle, they can affect the whole body. These medicines can cause side effects in
the mother, including drowsiness and nausea. They also can have effects on the baby.
Regional anesthesia. This is what most women think of when they
consider pain medicine during labor. By blocking the feeling from specific regions
of the body, these methods can be used for pain relief in both vaginal and cesarean
Epidurals, a form
of local anesthesia, relieve most of the pain from the entire body below the belly
button, including the vaginal walls, during labor and delivery. An epidural involves
medicine given by an anesthesiologist through a thin, tube-like catheter that's inserted
in the woman's lower back. The amount of medicine can be increased or decreased according
to a woman's needs. Very little medicine reaches the baby, so usually there are no
effects on the baby from this method of pain relief.
Epidurals do have some drawbacks — they can cause a woman's blood pressure
to drop and can make it difficult to pee. They can also cause itching, nausea, and
headaches in the mother. The risks to the baby are minimal, but include problems caused
by low blood pressure in the mother.
Tranquilizers. These drugs don't relieve pain, but they may help
to calm and relax women who are very anxious. Sometimes they are used along with analgesics.
These drugs can have effects on both the mother and baby, and are not often used.
They also can make it difficult for women to remember the details of the birth. Discuss
the risks of tranquilizers with your doctor.
Some women choose to give birth using no medicine at all, relying instead on relaxation
techniques and controlled breathing for pain. If you'd like to experience childbirth
without pain medicine, discuss this with your health care provider.
Things to Consider
Here are some things to think about when considering pain control during labor:
Medicines can relieve much of your pain, but probably won't relieve all of it.
Labor may hurt more than you expected. Some women who had said they want no pain
medicine whatsoever end up changing their minds when they're actually in labor.
Some medicines can affect your baby, making the baby drowsy or causing changes
in the heart rate.
Talking to Your Health Care Provider
You'll want to review your pain control options with the person who'll be delivering
your baby. Find out what's available, how effective they're likely to be, and when
it's best not to use some medicines.
If you want to use pain-control methods other than medicine, make sure your health
care provider and the hospital staff know. You might want to also consider writing
a birth plan that
makes your preferences clear.
Remember, many women make decisions about pain relief that they abandon —
often for very good reason — at the last minute. Your ability to endure the
pain of childbirth has nothing to do with your worth as a mother. By preparing and
educating yourself, you can be ready to decide what pain management works best for