Understanding Pain during Labour and Birth

Written by Tertia Alkema on January 22, 2011 in Pain Management - Comments Off

We are made to do this work and its not easy…I would say that pain is part of the glory, or the tremendous mystery of life. And that if anything, it’s a kind of privilege to stand so close to such an incredible miracle. Simone in Klasson 2001

We hope to clarify the mystery and fear of pain during childbirth with our articles about pain during labour and birth. It is most probably the area of childbirth that most women fear. Can I do this? What if?

Understanding why it happens and how best it could be managed, will assist all mothers to have a more positive birthing experience.

Take your time to read these articles that consist of this one, Understanding Pain during Labour and Birth, The Birthing Hormones Cocktail – Nature’s Secret, Natural Pain Relief Methods and Medicated Pain Relief Methods.

Visit them often to ensure you understand what pain in labour is all about and how your finely tuned body is programmed to cope with it.

Pain in General Explained

Pain is both a physical and emotional experience, much more than just the body’s nerve response to an injury or a change in a function of the body. Pain is a complex experience that is very personal (and sometimes isolated) for the individual person. It is invariably influenced by a person’s beliefs, culture, ideas, fears and feelings.

For the last 20 years or so, the concept of pain has been recognised as being what a person says it is, existing when they say it does and being as painful as they say they feel it. How an individual person views different types of pain will alter the way they react to that pain, and ultimately affect how they will feel about that pain after the experience.

Pain is transmitted to the brain by sensory nerve fibres. These nerves relay ‘sensation’ information (such as touch, heat, cold, sexual arousal, pressure and pain) from our bodies to our spinal cords and then on to our brains for interpretation.

The Gate Control Theory

The ‘Gate Control Theory’ remains one of the most respected understandings of one way our bodies can diminish the perception of pain.

The gate control theory is based on the fact that when the larger skin nerves (that sense touch, heat, cold and pressure) are stimulated, they are capable of overriding the smaller nerve fibres that sense the sharp, burning or aching pains. The larger nerve fibres carry the ‘sensory message’ to the spinal cord more rapidly and get priority, shutting ‘the gate’ as it were, to the pain messages being carried by the smaller fibres.

If the pain intensifies to a higher level the ‘gate’ can be pushed back open to a degree, making the pain sensation felt more intensely. This is the reasoning behind our natural instinct to ‘rub’ or massage our bodies when we hurt ourselves.

It is also the reason why natural therapies such as massage, cold or heat packs can alter the conscious pain sensation felt by a woman in labour, changing or modifying, the pain she experiences.

Other ways to stimulate the gate control is by changing position, walking, rocking, stomping and pelvic rocking. These movements activate receptors in the woman’s joints to help diminish pain. As the labour progresses and intensifies, methods using the ‘gate control’ can become less effective as the gate is ‘pushed back’ to a degree.

This is particularly so as the woman reaches the transitional phase of the 1st stage of labour, just before it is time to push. But remember those hormones! (See our post on Birthing Hormones)

Pain in Labour and Birth

The anticipation or the ‘expectation’ of pain can increase anxiety levels in a person and therefore increase the intensity of how they perceive the pain when it comes. For a woman who is fearful and anxious about labour, the need for pain relief can be higher.

It has also been suggested that women who feel they are in control of decisions about what is happening to them in labour, will perceive their pain as less intense and less threatening, as well feel more positive about the labour experience after the birth.

Labour pain differs from other kinds of pain in ways that make coping easier.

It is not a symptom of injury or illness: When pain signals that something is wrong, anxiety can increase painful sensations. Labour pain, however, is simply a sign that your body is working hard and well.

It is rhythmic: Contractions last no longer than a minute or so and come in a regular pattern with one to several (usually) pain-free minutes in between them. This means you can predict and prepare for each contraction and rest between them.

It intensifies gradually over time: Contractions almost always start off mild and gradually grow longer, stronger, and closer together, thus allowing you time to adapt.

It is self-limiting: Labour rarely takes more than 24 hours.

We have a secret in our culture, and it’s not that birth is painful. It’s that women are strong. Laura Stavoe Harm

A woman’s body is already organized and finely tuned to do this work. But it is important that a woman and their caregivers understand how to work with – and avoid disrupting – her body’s inborn knowledge, drive, and direction for giving birth and caring for her baby.

The key is that you should be realistic about labour pain. For most women labour and giving birth is painful.

Things to remember are:

That a woman’s experience of pain involves many factors and complexities and while most will describe labour as ‘painful’, this does not necessarily mean it was an unpleasant experience.
The description of labour pain is widely variable; it may be that other women’s stories will leave you feeling no closer to fully understanding what your labour pain will be like. Your ‘benchmark’ will only truly be established once you have experienced labour yourself. It could also be a very empowering experience.
Unrealistic and inflexible expectations can place unnecessary pressure on you. For some women, when the labour and birth don’t meet their expectations, feelings of disappointment, depression or even anger can be felt in the days, weeks, or months after the birth.
Be realistic about your labour pain. Just as fears and concerns can encourage you to source out and embrace different strategies for support, so too will being realistic about what your labour could bring.
Allow your body to move with labour pain, do not fight it, as this can intensify your perception of the pain. It is something you need to accept and let it flow through your body, not something that you must fight.
And remember, labour pain is not constant; it comes and goes, allowing the labouring mother to rest in-between the contractions.