PAIN DURING CHILDBIRTH
Version of Record online: 24 DEC 2010
2004 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 49, Issue 6, pages 553–554, November-December 2004
How to Cite
(2004), PAIN DURING CHILDBIRTH. Journal of Midwifery & Womens Health, 49: 553–554. doi: 10.1016/j.jmwh.2004.08.027
- Issue online: 24 DEC 2010
- Version of Record online: 24 DEC 2010
How Painful Is Giving Birth?
You've probably heard a lot of stories about giving birth. The experience is very different for each woman. The amount of pain is different for everyone. The kind and amount of pain you have changes throughout your labor.
Why Is Labor Painful?
During labor, your uterus pushes the baby down and stretches the opening of your uterus (cervix). Each time the uterus muscles flex, you may feel pain like a strong cramp. As your cervix and vagina stretch and open, you may feel a stretching, burning pain. Most contractions last 30 to 60 seconds, and you will be able to rest in between.
I Would Like Help With the Pain, But I Don't Want to Use Medicine. What Can I Do?
The flip side of this handout gives lots of tips for coping with the pain of labor. The less tense and afraid you are, the less painful your labor will be. Three things can help you labor successfully without using medications: knowledge about what to expect, belief in yourself, and emotional support and coaching during your labor.
Is There Medicine I Can Take for Pain if I Need It?
There are many types of pain relief available in a hospital. The most common pain medications are narcotics and epidural anesthesia.
What Are the Pros and Cons of Narcotics?
• They give fast pain relief (usually between 2 and 10 minutes).
• Most can be given directly into your bloodstream through an IV.
• They may help you relax and be more comfortable.
• They don't usually slow your labor.
• Narcotics do not last long (usually between 20 and 60 minutes).
• They may cause nausea.
• They may cause you to feel really “out of it” or sleepy.
• They may make the baby sleepy and make it harder for him or her to breathe right after birth or start breastfeeding.
• Narcotics don't take away all of the pain. They may make each contraction less painful.
What Is an Epidural?
An epidural numbs your body from the waist down. It involves putting a needle and then a small flexible tube into a space near the spine in your lower back. The pain medication flows through the tube and you lose feeling in your abdomen and legs. The medication will not make you or your baby feel sleepy or “out of it.” However, you will not be able to walk or get up to go to the bathroom. You may have a harder time pushing your baby out, because you won't be able to feel the contractions.
How Can I Tell Before Labor Starts What Is Right for Me?
• If you plan to give birth in a hospital, you can choose to use pain medicines. First, learn all you can about how much help and what possible problems can occur if you use the pain medicines that are offered where you are going to have your baby. Then ask yourself the questions listed here. The answers will help you decide on the best way for you to keep yourself comfortable during your labor.
• How strong is my desire to give birth without using pain medicines?
• Will I be happier with my birth after it is over if I go through labor without using medicine or will I be happier afterward if I use pain medicines?
• If my labor is normal and I am in more pain than I expected, do I want my helpers to talk me through it or do I want them to offer me pain medicine?
Remember that nobody knows ahead of time how painful or difficult your labor will be. Knowing your desires is the best place to start. Then when you are in labor, you need to be flexible and trust your support persons and caregivers to help you make decisions that are right for your experience then. The flip side of this sheet has some tips for coping with pain in labor.
COPING WITH PAIN IN LABOR
What Can I Do Before Labor?
• Stay active all during your pregnancy. You will have more strength to get through labor.
• Take childbirth classes. The more you know, the less you fear. Fear makes pain hurt more.
• Arrange for a birth coach or doula. Having a person whose only job is to support you will help you cope during labor and feel more satisfied with the experience.
What Can I Do During Early Labor?
• In early labor go for a walk or dance. The more you move, the less you hurt!
• Drink lots of fluids so you don't get dehydrated and eat lightly if you are hungry.
• Take a warm shower or bath.
What Can I Do During Active Labor? Find Your Rhythm.
All women who cope well during labor go back and forth between resting in between the contractions and movements that help cope with pain during the contraction. Each person has their own rhythm that works. You may
• Rest between contractions by being still or by rocking gently.
• Focus on your natural breathing. Awareness of breath relaxes you.
• Change positions often.
• Don't be afraid to make noise. You might moan, hum, or repeat comforting words over and over as you go through each contraction.
• Believe you can do it. You can!
• Remember why you are doing this. Your baby will be here soon!
What Can My Birth Coach Do During Labor?
• Help you find your rhythm and then help you during each part of it.
• Give you a back rub or hold your hand quietly.
• Offer you ice chips, water, or juice.
• Help you change positions and support your body.
• Keep the lights low and play soft music.
• Put a cold washcloth on your forehead.
• Put a warm washcloth on your lower back.
• Talk you through each contraction, supporting your movements and your noises.
• Cheer you on!
What Can My Health Care Provider Do During Labor?
• Answer your questions.
• Check your progress and give you direction.
• Assure you that things are going normally.
• Provide pain medication if needed.
FOR MORE INFORMATION
Pain and Pain Relief During Labor:
Childbirth.org: Articles on pain and pain relief methods http:www.childbirth.orgarticleslaborpainrelief.html
Maternity Center Association. MaternityWise.org: How Do I Get the Labor Support I Need? http:www.maternitywise.orgmwtopicslaborsupport How Will I Cope With Labor Pain? http:www.maternitywise.orgmwtopicslaborsupport
Doulas of North America (DONA) http:www.dona.org
This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to JMWH approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH suggests that you consult your health care provider.