How painful is labour?

Well, this is the 6 million dollar question…one that is virtually on every pregnant woman’s mind, and if I have £5 for every time I was asked this on my antenatal courses, I’d be a very rich woman.

Lets try and unpick this a little.

Every woman is different, we are all unique.  We all have genes from both our biological parents that can affect how we are biologically.  Women may also to a certain extent, have pre-dispositions to certain things within their biology. Some will have longer labours, shorter labours, smaller babies, larger babies, different shaped uteruses (or is that uteri?) that affect the position of their babies, I could go on, and on with examples, but I’m sure you get the idea.

The contractions of the uterus in spontaneous labour, will build up from very mild with a long break in between them, to becoming more intense with much shorter rest periods. This is a perfectly normal part of the labouring process. The contractions, tightenings, or surges (these are words that are used to describe the uterine contractions, in both birth preparation courses, and hypnobirthing).  Hypnobirthing practitioners are generally inclined to back away from using the word contraction, as contraction is associated, rightly or wrongly with pain (they don’t like the word pain either).

The intensity of these tightenings of the uterus will vary from woman to woman, and could depend on a variety of different things.  This list is not exclusive, purely to give you a starting point:

  • The position of the baby in utero – the optimum and most common position for a baby in the uterus for labour according to Sutton (2000), is an OA position (occipital anterior).  This is where the baby is curled up with its head firmly in the pelvis, and its back around the front of the bump, this helps the baby get into an optimum position to go through the birth canal.  Other positions for the baby, like the OP (occipital posterior) position may be slightly more challenging for the woman (as the baby may be slightly more out of alignment for movement through the birth canal, hence potentially causing labour to feel more challenging.
  • The birth environment – this is a whole other topic which will be addressed another time.  The birth environment will absolutely affect the woman’s labour hormone production which can have a massive effect on the feel of, and progression of her uterine contractions. If the labouring woman is feeling calm, relaxed, secure and private in her chosen place of birth, she will be producing a cocktail of hormones which will be positively working with her during labour, to help her labour progress in readiness for the birth of her baby. If the environment is right for the woman (and this is unique to every labouring woman), then the tightenings may in turn feel very different to those if she is feeling anxious and not producing these awesome hormones.
  • Hormones for labour – this is connected very closely to the birth environment, if the environment is right, the hormones will follow.  Get the environment wrong (for her) and the hormones may not be as prevalent, increasing the intensity of the labour surges.  Disclaimer: the woman’s environmental needs may change during labour too, so as birth partner, you need to be proactive and reactive to her needs!!
  • Mindset – this is a big topic too, which I will just skim the surface of here.  If a person has a negative outlook, they are more likely to have a negative experience.  Think about this – “thoughts become actions”!  If you are continuously being told that something will be hard, that you need to have medical support on hand just in case, it’s going to be painful, it will be the hardest thing you will ever do, you will need help, have all the drugs possible’ – this is what you will believe and this is how it will be perceived by you.  Surrounding yourself with positive thoughts and perhaps affirmations will help your positive mindset, leading to a potentially much more positive experience.  Consider doing a hypnobirthing course, this can have massively positive effects on labour for many women.  I can signpost you to some, just get in touch.
  • Knowledge is power – well sort of. If you have an understanding of the processes of labour (and I don’t mean go and do a degree in midwifery before having a baby) can have a positive and empowering effect on your labour.  By attending a birth preparation course will absolutely be enough (did you know I run these online, and at your own pace?!).  Having an understanding of labour and birth, will enable you and your birth partner (if you have one) to make informed decisions on your experience, and being part of the decision making with the health care team working with you will help you stay in control, and in turn have a positive experience.
  • The birth plan – oh how I dislike the word…plan!! (actual title of another article!!).  If the labouring woman (and birth partner if she has one) has thoroughly thought about every direction labour could take, they will be able to have a clear indication of what they are willing to try, or not to try at the time.  This will help with decision making and keeping in control during labour too.  Women are allowed to change their minds though!!
  • Pain management – (again another article topic). There are all variety of self-help skills and drugs available for women to use in labour and birth.  All of these will have different properties, and effects on both the woman and her baby, altering the perception of labour and the way she experiences it.  Self-help skills can be as good as medical options.

That’s a few reasons why women may feel their labour in different ways, and actually who are we to say how painful labour is.  It is an impossibility to compare each woman’s labour experiences just in terms of measurement of pain, as every womans labour experience and interpretation will be so very different, with so many variables to add into the equation.

Action: 

  • Listen to positive birth stories to encourage a positive mindset, the hormones, the environment etc.
  • Join a non-biased and non-judgemental birth preparation course to gain knowledge and understanding of the processes (did I tell you I run these online).
  • Really engage in discussions about your birth plan (did I say how much I dislike that word?) with your birth partner and midwife.
  • Be open minded, and willing to change.

Until next time

Nicky (Plymouths’ Mother hen)

Refs:

Sutton, J., & Scott,P. (2000). Understanding and teaching optimal foetal positioning. 

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