Understanding Labour Pain

One of the biggest fears people have around birth is the fear of labour pain. Birth is a normal, healthy life process.⁹ Often pain is perceived as a signal that something is wrong. In labour, though, the pain and the stress that results from it are actually productive.¹⁰

• Tells you how to move and what positions to be in to help promote good labour progress. This changes the shape of your pelvis and helps to shift the baby into the best position for birth. (e.g., many people who are experiencing back pain in labour will naturally lean forward or get on their hands and knees to reduce the sensation of pain. These positions can also help the baby to turn into a better position).¹⁰

• Signals the release of stress hormones in your baby, which help your baby adjust to the outside environment.^{1 3 10}

• Signals the release of endorphins; the body’s natural painkillers.^{1 10}

• Supports a feedback loop between the nerves in the pelvis and the brain to increase secretion of oxytocin (a hormone that increases the intensity of labour contractions).^{1 3 10}

• Results in the birth of your baby.

Anticipated:

• You can learn and practice coping strategies during pregnancy to help you prepare mentally, emotionally and physically for your labour.¹⁰

Intermittent:

• Contractions come and go with a break in between. Focus on the time between contractions to relax.
• Even if your contractions are 3 minutes apart, there are only 20 minutes of contractions and 40 minutes of rest in every hour.

Normal:

• Labour pain is usually an indication that everything is going the way it should be. It’s a sign that labour is progressing and not a sign that something is wrong (as pain is often seen).¹⁰
• Make sure you have support people by your side who believe that labour pain is normal and purposeful.¹⁰

Factors that may affect your experience of labour pain include:⁸

• Society’s expectations and beliefs about labour pain.
• Your confidence in your ability to cope with your contractions.
• Your labour environment.
• The philosophy of care of your healthcare provider.
• Your physical well-being going into labour.
• Your labour progress.
• Your history of trauma or history with a previous difficult experience with pain.

Pain vs. Suffering ⁵

It’s important to understand the difference between feeling pain and suffering in labour and birth.¹⁰ For you, it may mean the difference between coping with the pain or not. For your support person, knowing whether or not you are coping in labour will help them to determine how you will need to be supported.

There are many normal activities that we do that cause pain. Running can cause muscle pain because of a normal process that happens in our muscles when we use them during intense exercise. This doesn’t necessarily mean that the runner is suffering. The runner’s thoughts and emotional reactions to the pain will determine if they are suffering or not.

Childbirth educator, doula and author, Penny Simkin, describes how your partner can check for suffering during labour, by asking you the question: What was going through your mind during that last contraction?

• If the thoughts or images are positive and you are using the 3Rs - Relaxation, Rhythm, & Ritual, then you are most likely coping with the pain and not suffering.
• If the thoughts or images you experienced were frightening to you, then you will need some reassurance, support, and encouragement to get back to using strategies that were working for you. The Take Charge Routine ⁵ (pg. 8) may be helpful here.

Penny describes the following positive coping responses:

• Using positive visualizations.
• Using behavioural rituals (3Rs - relaxation, rhythm and ritual).
• Using internal mental rituals (self-talk).

Penny also suggests using a code word that you share with your partner, support people and healthcare providers. When you use this code word, you are absolutely in need of medical pain relief because you are suffering. Many people hit a wall where they feel they can no longer cope, but really just need some extra support to get them back to coping again. If this code word is not used, you should never be pressured to use medical pain management interventions. This can be very empowering as an additional tool to ensure your labour pain management wishes are respected.

Video

• Watch Penny Simkin explain how to use a Code Word during labour and birth →

It is important to find credible sources of information and learn how to make informed decisions to have the best birth for you.