Is normal delivery pain bearable?

Giving birth is one of the most intense experiences a woman can have. The anticipation of labor and delivery is filled with both excitement and anxiety. Many expecting mothers wonder if a normal vaginal delivery will be too painful or if the pain is bearable. This is a valid concern, as labor does involve intense waves of pain during contractions as the cervix dilates and the baby descends through the birth canal. However, there are many ways to manage the discomfort and make normal delivery as comfortable as possible.

What Causes Pain During Delivery?

Labor pain is caused by a combination of factors:

Contractions – Contractions are the tightening and shortening of the uterine muscles. As contractions increase in frequency and intensity, they cause pain and discomfort in the lower abdomen and back.

Dilation of the cervix – For vaginal delivery, the cervix must open up from 0 to 10 cm. The stretching and thinning of the cervical tissue causes cramping and aching sensations.
Baby descending – As the baby moves down the birth canal and puts pressure on the cervix and vagina, it leads to intense sensations, stretching, and burning or stinging pain.
Back labor – When the baby is positioned with the back of its head against the mother’s spine, more intense pain can radiate from the lower back down through the buttocks and legs.

Perineal stretching – As the baby’s head crowns and the perineum stretches, this can cause a burning or stinging sensation.

The intensity of labor pains varies significantly from woman to woman based on factors like the size of the baby, the position of the baby, the shape of the mother’s pelvis, and the location of the placenta.

Stages and Types of Labor Pain

Labor is divided into three stages with varying degrees of discomfort:

Early labor

This initial phase is when the cervix starts thinning and dilation begins. Contractions are usually mild and last about 30-45 seconds. The pain is comparable to moderate menstrual cramps. Women can often continue their usual activities during early labor.

Active labor

In this more advanced stage, contractions become stronger, longer, and closer together. The pain intensifies as the cervix opens to 6-8cm. Contractions may last 60-90 seconds and occur every 3 to 5 minutes. Active labor is often considered the most painful part of childbirth. Women feel intense cramping in the lower abdomen and back.

Transition

The most difficult part of labor is the transition phase. Contractions are extremely strong, frequent (less than 2 minutes apart), and can last for 60-90 seconds. Pain peaks as the cervix fully dilates to 10cm to allow the baby to pass through. Women describe sensations of extreme pressure, burning, and stretching. This stage may last 15 minutes to an hour before the urge to push arises.

Second stage

This involves pushing the baby through the birth canal and out of the vagina. Contractions may lessen slightly but pressure significantly increases. Pushing provides some relief. There is often pain and stinging at the perineum as the head crowns. This stage can take minutes to hours depending on whether it’s the first vaginal delivery.

Coping Techniques for Labor Pain

There are many medical and non-medical options to help cope with the discomfort of childbirth:

Medical Pain Management

Epidurals – This is the most popular and effective method of labor pain relief. Epidural anesthesia blocks nerve signals from the uterus and birth canal. Though you remain awake, your lower body feels numb. Epidurals allow you to rest during labor and push effectively during delivery.

Narcotics – Intravenous narcotics like fentanyl or morphine provide systemic pain relief. However, they cross the placenta and may affect the baby’s heart rate.
Spinal blocks – A single shot of anesthetic is injected into the fluid around the spinal cord. This offers rapid and short-term relief as an alternative to epidurals.
Pudendal blocks – Local anesthetic is injected into the vaginal area to block pain during the pushing stage.

Natural Pain Relief Techniques

Breathing – Rhythmic breathing helps women focus during contractions. Inhale through the contraction and exhale while relaxing the body.
Relaxation and visualization – Imagine a peaceful scene and relax each muscle group between contractions.
Massage – Having a partner apply counterpressure to the lower back can help during labor.

Hydrotherapy – Immersion in a warm tub or shower helps relieve tension.
Birth balls – Rocking, bouncing, or swaying on a birth ball shifts the baby’s position and strengthens contractions.
Transcutaneous electrical nerve stimulation (TENS) – TENS machines transmit low-voltage electrical currents through electrodes on the skin to interfere with pain signals.

Acupuncture and acupressure – Trained practitioners stimulate certain pressure points on the body to manage discomfort.

Medications

Nitrous oxide – Also known as laughing gas, this can be self-administered through a mask during labor for sedation.
Opioid painkillers – Medications like meperidine block pain signals but may cause drowsiness.

The chosen method depends on the woman’s preferences, access to resources, labor progression, and health risks. Most utilize a combination of options at different stages.

Positioning Techniques

Switching positions throughout labor can help ease pain and aid the descent of the baby:

Walking – Movement helps strengthen contractions in early labor. Changing positions provides relief.

Slow dancing – Swaying with a partner applies counterpressure on the lower back.
Sitting up – Sitting upright or leaning forward relieves back tension.
Side-lying – Lying on the side stabilizes the pelvis and minimizes pressure on blood vessels.

Squatting or kneeling – These upright positions use gravity to move the baby down and open up the pelvic outlet.
Hands and knees – Being on all fours expands the pelvic diameter to aid rotation and descent.

Medical staff can also suggest optimal positions during pushing and delivery depending on the baby’s station in the birth canal.

Perception of Labor Pain

Every woman perceives and copes with labor pain in her own way. Some factors that influence individual experiences:

Physical condition – Women who are fit and active with strong core muscles may handle labor better.
Size and position of the baby – A larger baby or abnormal positioning often increases pain.

Induction of labor – Induced contractions may be longer, stronger, and more painful.
Fear and anxiety – Being tense and afraid can heighten pain responses.
Preparedness – Childbirth education lowers fear and improves coping abilities.

Support system – Continuous emotional support and encouragement from loved ones reduces stress.
Prior pain experiences – Women with chronic pain or traumatic injuries may have higher pain tolerance.
Cultural background – Socialization regarding childbirth influences expectations and expression of pain.

Lower levels of pain do not indicate weak or inefficient labor. Some women progress quickly with minimal discomfort.

Tips for Coping With Labor Pain

Here are some key tips for dealing with the intensity of childbirth contractions:

Attend childbirth classes to learn techniques like breathing, massage, and positioning.

Read up on labor stages so you know what to expect at each phase.
Create a birth plan to decide your preferences for medical interventions.
Stay hydrated and nourished to keep your energy up for labor.

Bring focal points like photos, music, or aromatherapy to provide distraction.
Pack loose, comfortable clothing and your own pillows and blankets.
Have continuously available support from your partner, doula, or nurses.

Stay as relaxed as possible between contractions to conserve strength.
Use positions that open your pelvis and work with gravity.
Let your care provider know if pain becomes unmanageable at any point.

Benefits of an Unmedicated Delivery

While epidurals are extremely effective for pain relief, some women may choose to attempt an unmedicated vaginal delivery. Benefits can include:

Increased mobility during labor to find comfortable positions.
Ability to push instinctively in alignment with contractions.

Lower risk of side effects like maternal fever or drops in blood pressure.
Shorter second stage of labor and reduced need for forceps or vacuum assistance.
Better sense of control and empowerment over the birthing process.

Improved initial bonding and breastfeeding response after birth.

However, there are some risks if you cannot handle the intensity of unmedicated labor:

Exhaustion, anxiety, and trauma from severe pain.

Inability to push effectively due to pain, causing fetal distress.
Higher chances of needing an emergency C-section if labor stalls.
Rare complications like uterine rupture if induction is required without pain relief.

It is critical to remain flexible and keep an open mind about pain management options.

When to Get an Epidural

Here are some general guidelines on when to request an epidural during labor:

Active labor phase when contractions are strong, regular, and difficult to talk through.

Cervix is dilated to at least 4-5cm.
Contractions do not ease up significantly between peaks.
Natural techniques are no longer providing adequate relief.

Exhaustion sets in between contractions.
You are unable to relax or rest at all.
Rising anxiety or tension is felt as pain intensifies.

Typically, this occurs during active labor after 4-5 hours of difficult contractions. Early epidurals may stall labor if given too soon. But don’t wait until pain is intolerable, as it takes time to administer and you may be too distressed.

Risks of Delaying Pain Relief

While a positive childbirth experience does not require medication, it’s important not to disregard your pain limits and fatigue levels. Potential consequences of waiting too long for an epidural or other interventions include:

Exhaustion and inability to effectively push when fully dilated

Prolonged labor from tense muscles and stalled progress
Elevated blood pressure and heart rate
Hyperventilation or oxygen deprivation for mother and baby

Intense emotions like fear, panic, anger, and trauma
Higher chance of needing an emergency C-section
Postpartum depression or emotional healing difficulties

Staying immersed in severe pain makes labor counterproductive by tensing the muscles and slowing the descent. Communicate any concerning pain levels early on.

How to Handle Pain in Early Labor at Home

Here are tips for managing discomfort when laboring at home before active labor:

Have light snacks and hydrating drinks to keep energy levels up.

Walk around and change positions periodically.
Lean forward on a birthing ball or pillow stack.
Sway, rock, or use mini-squats during contractions.

Use breathing techniques and have a focal object for meditation.
Take a shower or use a heating pad for lower back soreness.
Listen to calming music and limit environmental stimuli.

Have your partner use massage or counterpressure techniques.
Rest lying down on your side while you can.
Consider a TENS machine for painless stimulus.

Once contractions intensify, become very close together, or your water breaks, it’s time to head to the hospital or birthing center.

Is Normal Delivery Pain Bearable?

Labor and childbirth involves intense sensations, but there are many effective options available today to reduce suffering. With proper preparation, support, positioning, and coping methods, most women can withstand the discomfort of a normal delivery.

While the pain is challenging, it is productive pain that leads to the joy of meeting your baby. Focus on working with your body’s natural process. Stay attuned to your emotions and don’t hesitate to request pain interventions as needed. The right combination of techniques makes normal delivery pain a manageable and empowering experience for most women.

Conclusion

Labor is undoubtedly painful, but the wide range of medical interventions and natural techniques available today provides many choices for managing childbirth discomfort. While an unmedicated vaginal delivery is possible for some women, there is no shame in opting for an early epidural or other pain relief. It is important to let go of expectations and remain flexible during the challenging process of labor. Preparing your mindset, educating yourself, and utilizing all available resources will give you the best chance of feeling in control and having a positive birth experience. Most importantly, listen to your body, communicate with your providers, and trust your instincts. With the proper support and coping methods, normal delivery pain is bearable for the majority of women.