How Painful Is Labor and Delivery?

While labor and delivery are expected to be painful, there are many ways to manage the pain. Labor pains vary from woman to woman and even one pregnancy to the next. Pain during labor is described as extreme menstrual cramps, strong cramping, severe pressure, extremely strong waves similar to diarrhea cramps, bad back pain, an achy feeling, and a broken bone.
While labor and delivery are expected to be painful, there are many ways to manage the pain. Labor pains vary from woman to woman and even one pregnancy to the next. Pain during labor is described as extreme menstrual cramps, strong cramping, severe pressure, extremely strong waves similar to diarrhea cramps, bad back pain, an achy feeling, and a broken bone.

Labor and delivery are painful, but it’s a manageable pain.

A survey by the American Society of Anesthesiologists (ASA) found that 46% of first-time mothers said labor and delivery pains they experienced with their first child were better than they expected. Ninety percent of women said pain management during labor and delivery was effective, no matter what method they chose. 

Women experience pain during labor and delivery differently, and it can also vary in the same woman for each pregnancy. Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix which can be described as:

Most women find the most painful part of labor and delivery to be the contractions, while some others may feel pushing or post-delivery is most painful. Pain during labor and delivery may also be caused by pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina.

Sometimes, it’s not the pain of contractions that is most difficult, but the fact that they don’t stop and as labor continues, there is less time between contractions to relax. 

Being proactive in pain management is important, which can mean choosing an epidural right away or using other medical or alternative pain management techniques. Expectant mothers can talk to their obstetricians and anesthesiologists about pain management methods. It is a good idea to have a birth plan to make sure your preferences are clearly outlined. 

Things to consider regarding pain control during labor:

  • Medications may significantly reduce pain, but probably won't relieve all of it
  • Labor may hurt more than expected and sometimes women who wanted no pain medicine change their minds when in labor
  • Some medicines can affect the baby, causing drowsiness or changes in the heart rate

Many expectant mothers use a combination of methods. Pain management during labor and delivery may include: 

  • Medical 
    • Epidural (most common option) 
      • A form of local anesthesia that delivers medicines through a catheter inserted into the mother’s back
      • An advantage is that very little medicine reaches the baby, so there are few to no effects on the baby 
    • Medication delivered through an IV or injection
      • Analgesics for pain
      • Regional anesthesia 
      • Tranquilizers to calm and relax anxious mothers
    • Spinal block
    • Nitrous oxide (rarely used)
  • Complementary methods 
    • Breathing
    • Water birth
    • Massage or counterpressure
    • Hypnosis
    • Yoga
    • Meditation
    • Walking
    • Changing position
    • Taking a bath or shower
    • Listening to music
    • Distracting yourself by counting or performing an activity that keeps your mind otherwise occupied

Before delivery, there are some things a mom-to-be can do to prepare for birth and help with pain during labor: 

  • Exercise regularly to help strengthen muscles, increase endurance, and prepare the body for the stress of labor 
    • Consult your doctor to learn about exercise that is appropriate and safe
  • Childbirth classes
    • These teach different techniques for handling pain, from visualization to stretches designed to strengthen the muscles that support the uterus
    • Lamaze technique 
      • Most widely used method in the United States
      • Teaches women ways they can decrease their perception of pain, through relaxation techniques, breathing exercises, distraction, or massage by a supportive coach
      • This technique takes a neutral position toward pain medicine, encouraging women to make an informed decision about what is right for them
    • Bradley method (also called Husband-Coached Birth)
      • Emphasizes the active participation of the baby's father as birth coach
      • A goal of this method is to avoid use of medications unless absolutely necessary
      • Focuses on proper nutrition and exercise during pregnancy and relaxation and deep-breathing techniques as a method of coping with labor
References
https://www.asahq.org/about-asa/newsroom/news-releases/2018/05/pain-of-labor-and-delivery

https://kidshealth.org/en/parents/childbirth-pain.html