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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


Importance of labour pain

Factors that may affect your perception of pain

Pain vs. suffering

Importance of Labour Pain:

Labour pain differs from pain that you experience when you injure yourself because it is: 

P - Purposeful
A - Anticipated
I - Intermittent
N - Normal


Labour Pain:


Tells you how to move and what positions to be in to help promote good labour progress by changing the shape of your pelvis and shifting the baby into the best position for birth. (eg. many moms who are experiencing back pain in labour will naturally lean forward or get on their hands and knees to reduce the sensation of pain but 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.


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


  • 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.


  • 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 perception of pain include:8

  • You lack confidence and are not prepared for labour and birth.
  • You feel overly fearful or anxious about the process of labour and birth.
  • You are not well-rested.
  • You do not have a support person to be with you during labour and birth (personal &/or professional).
  • You are not able to change your position or move around during labour.
  • Your baby is in a position that gives you more back pain.
  • Your labour has been induced or is longer than expected or you have had other medical interventions.
  • You have a low tolerance for pain.
  • You have experienced a traumatic experience in your past.
  • You’ve had a difficult previous experiences with pain.
  • You are hungry or thirsty.
  • You have a full bladder.

Pain vs. Suffering 5

It’s important to understand the difference between feeling pain and suffering in labour and birth.10 For the birthing mother, it may mean the difference between coping with the pain or not. For the support person, knowing whether or not a woman is coping in labour will determine how she 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.

Pain Suffering
Pain is an unpleasant physical sensation. Suffering is an emotional reaction to the physical sensation that may lead to trauma.

The partner can check for suffering during labour, by asking the question: “What was going through your mind with that last contraction?”

  • If the images are positive and she is using her 3Rs - Relaxation, Rhythm, & Ritual (PDF20KB), then she is most likely coping with the pain and is not suffering.
  • If the thoughts or images she experienced were frightening to her, she will need some reassurance, support and encouragement to get back to using strategies that were working for her. The Take Charge Routine 5 (pg. 8) may be helpful here.

Positive coping responses are any that include:

  • Using positive visualizations.
  • Using behavioural rituals (3Rs - relaxation, rhythm and ritual) (PDF 20KB).
  • Using internal mental rituals (self-talk).
  • Using a code word that you share with your partner, support people and healthcare providers. This can be very empowering as an additional tool to ensure your pain management wishes are followed.


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

Date of creation: February 9, 2016
Last modified on: May 28, 2019

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1Buckley, S. (2015, January 13). Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. Retrieved from
2England, P., & Horowitz, R. (1998). Birthing from within. Albuquerque: Partera Press.
3Goer, H. (1995). Obstetrical myths versus research realities: A guide to the medical literature (p. 252). Westport, Connecticut: Bergin & Garvey.
4National Collaborating Centre for Women's and Children's Health (UK). (2014). Intrapartum care: Care of healthy women and their babies during childbirth - Chapter 8: Coping with pain in labour - non-epidural. Retrieved from
5Simkin, P. (2007). Comfort in Labor: How you can help yourself to a normal satisfying childbirth. Retrieved from
6Simkin, P., Whalley, J., Keppler, A., Durham, J., & Bolding, A. (2010). Pregnancy childbirth and the newborn: The complete guide. (4th ed., p. 206-207). New York: Meadowbrook Press.
7Singata, M., Tranmer, J., & Gyte, G. (2013, August 22). Eating and drinking in labour. Retrieved from
8Best Start Resource Centre. (2016). Pain Medications in Labour. Retrieved from
9Public Health Agency of Canada. (2017, December 05). Chapter 1: Family-centred maternity and newborn care in Canada: Underlying philosophy and principles. Retrieved from
10Bonapace, J., Gagné, G., Chaillet, N., Gagnon, R., Hébert, E., & Buckley, S. (2018). No. 355-Physiologic Basis of Pain in Labour and Delivery: An Evidence-Based Approach to its Management. Journal of Obstetrics and Gynaecology Canada, 40(2), 227-245.