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 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.1310
Signals the release of endorphins; the body’s natural painkillers.110
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).1310
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 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.
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 Routine5 (pg. 8) may be helpful here.
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.
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 https://www.ncbi.nlm.nih.gov/books/NBK328260/
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.
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.