Giving birth is one of the most painful experiences a woman can go through. The level of pain experienced during childbirth varies greatly from woman to woman. Some describe it as very manageable while others say it is the worst pain they have ever felt. There are a few key reasons why giving birth hurts so much for some women:
Contractions
Contractions are the tightening and shortening of the uterus muscles that help dilate the cervix and push the baby down the birth canal. Contractions increase in strength and frequency as labor progresses. By transition stage (the end of the first stage of labor before pushing begins), contractions are very strong and painful, coming every 2-3 minutes and lasting 60-90 seconds. The pain from contractions comes from the squeezing and tightening sensation of the uterine muscles as well as from pressure placed on the cervix. For some women, back labor caused by the positioning of the baby can significantly increase the pain felt during contractions.
Dilation of the Cervix
For labor to progress, the cervix must open from closed to 10cm dilated. This dilation is what allows the baby to pass through the birth canal. The cervix has many pain sensors and the process of dilating can be very painful for some women. As the cervix widens, the nerve endings in the cervix get stretched and this causes a lot of discomfort.
Baby Descending Through the Birth Canal
As contractions continue, the baby is pushed down further into the birth canal. This increases pressure and stretching of the vaginal canal and vulva. For some women, the intense burning and stinging sensations from the perineum and vaginal tissues stretching can make this stage highly painful. Even women who have an epidural may still feel this pressure.
Perineal Tearing
Many women experience perineal tearing during childbirth as the baby’s head stretches the vaginal opening. Perineal tears can be mild to more severe involving the perineal muscles and anal sphincter. If the perineum is not well supported or the baby descends too quickly, extensive tearing is more likely leading to a lot of postpartum pain and increased healing time.
What Makes Birth More Painful?
While all labors bring hard work and some degree of pain, there are factors that can make the birth process much more painful for some women:
No Epidural
Getting an epidural injection for pain relief can significantly ease the pain during labor. Without an epidural, women feel the full intensity of contractions and the baby passing through the birth canal. An unmedicated birth may be very painful, especially during transition and delivery.
Large Baby Size
A larger than average baby usually leads to a more difficult delivery, increasing the risk of extensive tearing or needing an episiotomy. Larger babies put more pressure on the perineum leading to greater pain and discomfort.
Position of the Baby
Babies in the posterior position where the baby’s head is face up instead of face down can lead to more back labor. Back labor causes intense lower back pain that can be worse than regular contractions. The poorly positioned baby must rotate further to deliver, also increasing pain.
Long Labor
The longer a woman labors, the more pain and exhaustion she experiences. Labors exceeding 12-24 hours are linked with increased rates of perineal trauma and postpartum pain due to the prolonged pressure and strain.
First Labor
First-time moms generally experience longer labors and are at greater risk for tearing during delivery. The cervix has never dilated before and the perineum has not undergone childbirth, contributing to increased pain compared to subsequent births.
Small Pelvis Size
Women with a narrow pelvic opening may have obstructed labor leading to pain from the baby not descending properly through the birth canal. A small pelvis causes increased friction against the birth canal.
Induction Methods
Being induced with medications like Pitocin makes contractions longer, stronger and more frequent than natural labor. Being induced when the body is not ready can increase the pain experienced.
Emergency C-Section
Needing an emergency C-section is extremely painful due to attempts at vaginal delivery before deciding surgery is necessary. The labor stalls leading to exhaustion while the abdomen is inflamed and irritated from prolonged contractions.
How Women Cope with the Pain
There are a variety of options women can consider to help manage and cope with the pain during childbirth:
Breathing Techniques
Patterned breathing is an effective non-medical way to cope with contractions. Slow, deep breathing through the peak of each contraction can reduce tension.
Massage
Having a partner apply counterpressure to the lower back during labor helps relieve back pain from contractions. Massaging areas of tension or pain helps distract the laboring woman.
Water Immersion
For women who can labor in a bathtub, being immersed in water provides relief. The water acts as a natural pain reliever and enables the woman to move freely.
Epidural Anesthesia
This is the most common and effective medical method for managing labor pain. An epidural numbs the nerves transmitting pain signals from the uterus and birth canal. Pain relief is significant but mobility is limited with an epidural.
Nitrous Oxide
Also known as laughing gas, inhaling nitrous oxide provides pain relief without numbing sensation. Women remain cognizant while relaxing between contractions.
Narcotics
Injections like fentanyl or butorphanol target pain receptors for several hours of relief. However, narcotics can cause drowsiness and nausea.
Transcutaneous Electrical Nerve Stimulation (TENS)
TENS units use electrical impulses through electrodes on the back to interfere with pain signals to the brain. While research is limited, some women receive pain relief from TENS.
Intradermal Water Injections
Sterile water papules injected into 4 points of the lower back can relieve back labor pain for up to 2 hours without numbing. Not all providers offer this option.
Acupuncture
Getting acupuncture before or during labor at specific points activates natural painkillers. More clinical evidence is needed but acupuncture holds promise for natural pain management.
Hypnobirthing
Using meditative relaxation techniques, visualization, and affirmations during birth helps reframe the perception of pain and invoke a deeply calm state. Taking hypnobirthing classes helps prepare.
Conclusion
Giving birth can involve intense and difficult physical sensations ranging greatly in severity and duration for each woman. While extreme pain is common during childbirth, there are many medical and non-medical options available to help reduce suffering and empower the mother. Using informed coping methods along with adequate labor support enables women to work through the pain purposefully in bringing new life into the world. Though challenging, women draw on inner strength and resilience shaped by both biology and culture to endure the temporary pain of childbirth. The joy and bond of meeting their baby eclipses the struggle of labor and delivery for most mothers.