How bad does giving birth hurt

Worried about the pain of labor and delivery? It’s not as bad as you think!

CHICAGO – Few things are more daunting for first-time moms than the prospect of childbirth. They wonder: Will my baby be OK? What will labor and delivery be like? How painful will it be, and can I handle it? Moms who have been there offer the low-down on labor and delivery and their message is comforting. Yes, childbirth is painful. But it’s manageable. In fact, nearly half of first-time moms (46 percent) said the pain they experienced with their first child was better than they expected, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA) in honor of Mother’s Day.

The survey findings suggest that being proactive in managing pain with your physician anesthesiologist is important, whether laboring moms demand an epidural right away, choose other medical pain management methods, use complementary techniques only or opt for a combination. Nine out of 10 women said pain management was effective, no matter what method they chose. (Click here to download infographic)

But the survey also revealed that many first-time moms held some false beliefs about labor pain management before they experienced childbirth:

• 74 percent thought you couldn’t have an epidural after a certain time in labor (you can have one up until the baby’s head begins emerging, known as crowning)
• 44 percent feared pain at the epidural injection site would last for a prolonged time
• 26 percent believed an epidural slows labor
• Most concerning, 20 percent believed only one pain management option could be provided during labor and 16 percent thought about it but didn’t know

Expectant mothers should work with their health care providers, including their physician anesthesiologist, to discuss what pain management methods may work best for them. They should talk to their physicians to find out who will administer their anesthesia if they decide to have pain medication during labor. Anesthesia care should be led by a physician anesthesiologist, a medical doctor specializing in anesthesia, pain and critical care medicine, who will work with all of the mother’s physicians to develop and administer her pain management plan.

“First-time mothers need to know that a wide variety of options exist to manage pain, from epidural to massage, nitrous oxide to breathing techniques and that it’s acceptable to change methods or use a combination during nearly every stage of labor,” said ASA President James D. Grant, M.D., M.B.A., FASA. “But it’s also important to be flexible, since it may be necessary to change pain management methods based on the labor process itself.”

When it hurt most and what it was like

While slightly more than half said having contractions was the most painful aspect of delivery, about one in five noted pushing or post-delivery was most painful. Moms 18 to 39 were more likely to say post-delivery pain was the most painful aspect than those 40 and older. The most common description of the level of pain experienced was extreme menstrual cramps (45 percent), while 16 percent said it was like bad back pain and 15 percent compared it to a broken bone.

Health and safety are top of mind

It’s no surprise that when choosing a pain relief option, nearly all mothers (99 percent) said the health and safety of themselves and the baby was an important factor in their decision. Not far behind was making sure the pain relief option didn’t delay the labor process (86 percent) as well as being able to enjoy the labor and delivery experience (84 percent). But the importance of other factors diverged depending on the pain method chosen. Having no pain during labor was very or somewhat important to women who chose medical methods (epidural, medication delivered through an IV or injection, spinal block or nitrous oxide) only (79 percent) compared to women who opted for complementary methods (breathing, water birth, massage, visualization or hypnosis) only (37 percent). Being able to move around during labor was important to 90 percent of moms who only had complementary methods, while just 60 percent of moms who had medical methods only agreed.

So, what pain management did they choose?

While the epidural reigned supreme as the most common option, chosen by 73 percent, 40 percent of women used complementary methods. Additionally, pain management during labor and delivery may not be “one size fits all,” with 31 percent having used both medical and complementary methods. More than half used medical methods only and 9 percent chose complementary methods only. Sixty-five percent of women who had medical options only said they were very effective in managing pain, while 39 percent who had complementary methods only said they were very effective.

And while nitrous oxide has received a lot of attention recently, the survey results suggest it’s rarely used. Only 2 percent of moms had nitrous oxide, and none 40 and older or who lived in the Midwest used it to manage labor pain. Before childbirth, slightly more than 1 in 10 thought nitrous oxide relieved pain and 63 percent didn’t think about it at all. “This suggests that despite the buzz, nitrous oxide may not be widely available yet, or that mothers aren’t convinced it would be very helpful,” said Dr. Grant.

In the future

If they were to give birth again, most moms would choose the pain management method, whether medical and/or complementary, they originally chose during their first childbirth, with the majority (60 percent) opting again for an epidural to manage their pain.

Women were split on the pain management advice they would give to first-time prospective moms – 21 percent would recommend getting an epidural as fast as possible, while 20 percent say try complementary methods first and if they don’t work, try other options. However, 43 percent of mothers agree that choosing one’s pain management method is a personal decision and you need to opt for those that work best for you.

“Every woman’s pain during labor is different and talking with your health care provider and physician anesthesiologist can help you decide which pain management method will give you the best labor and delivery experience,” said Dr. Grant. “Women may choose to use none, some or more than one pain management method depending on how labor progresses."

The 10-question ORC International CARAVAN® Omnibus Survey was conducted online April 3-11 among 912 mothers (18 years or older) of children ages 0-8, whose first child was born either via vaginal childbirth or Cesarean section (C-section) after the onset of labor. Ultimately, 73 percent had a vaginal childbirth.

For more information about pain management during labor and delivery and the importance of seeing a physician anesthesiologist, visit asahq.org/labor.

The American Society of Anesthesiologists
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring that physician anesthesiologists evaluate and supervise the medical care of patients before, during, and after surgery to provide the highest quality and safest care that every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Like ASA on Facebook; follow ASALifeline on Twitter.

# # #

How Painful Is Childbirth, Really?

Moaning, screaming, and cursing. These are some of the pleasant sounds commonly associated with childbirth.

You’ve likely seen birth graphically depicted on television, or if you’re pregnant, all of your family and friends may have decided to share their harrowing birth stories with you. If you’re like most women, this has led to a lot of fear about the amount of pain you’ll face during labor.

Is this really the truth about birth though? How much pain will you actually experience? Can you do anything to diminish that pain? While birth is different for everyone, we’ve got the information, tips, and tricks to help you feel prepared for the pain of childbirth.

Every person’s experience with birth will be different. Pain is subjective and can vary greatly. This means that you may have a very different pain experience from even your mother or sister.

It’s important to remember that the pain of childbirth is a manageable one, and both medicated and more holistic pain relief measures like visualization and massage are available.

Despite what you may have seen on YouTube or elsewhere, there’s no reliable unit to measure pain. Back in the 1940s, researchers tried to employ a device known as the dolorimeter, which used the heat from a light source, to establish levels of pain.

However, this measurement fell out of favor with growing evidence that pain isn’t solely dependent on an isolated physical sensation. Rather, it’s affected by a person’s fears, mood, memories, and personality, as well as factors like the duration and overall experience of the pain source.

Your healthcare provider will likely ask you to track and quantify your pain by rating it on a scale. They may discuss the intensity of the pain and your feelings about your ability to work through or manage it. This information will help them determine the appropriate pain relief options with you.

Pain is not necessarily consistent during the labor process, and you’ll probably experience breaks from it between contractions or while pushing. Although, you may notice though that it increases after your water breaks or as labor picks up, and that some elements of the pain are temporary while others continue for a period of time after giving birth.

When you think about the pain of childbirth, just remember that it’s purposeful, anticipated, intermittent, and a necessary part of your baby coming into this world!

You can expect to experience a variety of sensations during the end of your pregnancy and labor.

During pregnancy, you may experience Braxton-Hicks contractions, which are usually irregular and inconsistent. They tend to be felt in the abdominal area and make the belly feel tight, causing discomfort more than pain.

One thing that sets these contractions apart from labor contractions is that they don’t become more consistent, stronger, and longer. (If you would like to reduce the discomfort of Braxton Hicks, you can try drinking some more water, changing position, or resting on your left side.)

Early labor

In the early stages of labor, contractions will increase in intensity and frequency as they fall into a steady pattern.

Early labor contractions will usually cause the abdomen to feel tight to the touch. You may also experience a dull backache, feelings of pressure in the abdomen and pelvis, and sensations similar to those of intense menstrual cramping.

When contractions begin, they may only be 30 to 45 seconds in length with several minutes of rest in between.

Active labor

As labor progresses, contractions may feel like they are wrapping around your body from the back to the front. You may also begin to notice cramping and discomfort in your legs as the contractions become more frequent and last closer to 1 minute in length.

When you’re approximately 8 centimeters dilated, you may have 30 seconds to 1 to 2 minutes between contractions as you prepare to enter the pushing stage of labor. During this time it’s not uncommon to feel lightheaded, nauseous, and have hot flashes or chills.

Pushing

When you are fully dilated (around 10 cm) and it’s time to push, you may feel an intense pressure that feels like you need to poop. You can relax a little knowing that your body is just telling you that it’s ready for you to help push out your baby.

During this period, you’ll typically be instructed to push with the peaks of your contractions. Because you’re pushing with the contractions, many women find these contractions less painful than the contractions helping them to dilate.

Other parts of the experience may also cause discomfort or pain, including an episiotomy or vaginal tearing. You may also feel muscle pain or fatigue from pushing or experience uncomfortable side effects from medications used during labor.

If you’re feeling nervous about giving birth, there are things you can do before and during labor to decrease your pain (and increase your chance of having a positive birthing experience!).

Before giving birth

Exercise frequently

While you may need to modify your normal exercise plan, it’s worth continuing to exercise during pregnancy. Regular exercise during pregnancy not only helps control your blood pressure, mood, and weight but also can help keep your body in shape for the work of labor.

Take a birth preparation class

Knowing what’s ahead can help you relax and feel more comfortable during labor. Most birth preparation classes include instruction on comfort measures during labor, so you and your partner can get ideas and practice before the big event. (While you’re at it, you may also want to sign up for a baby care or breastfeeding class!)

Eat well and take your prenatal vitamins

It’s important to put the right nutrients in your body to help your baby grow properly and give yourself energy for labor.

Consider optimal fetal positioning

It’s easier to birth your baby when they’re in an optimal position. If your baby is breech or transverse, you may want to consider actions that will encourage them to shift their position… before you go into labor!

During labor

Pain relief during labor is a personal choice. You can try any combination of the following methods.

Breathing techniques

Whether you choose to follow a particular breathing routine during labor or just need to do some low vocalizations to help you through the more intense contractions, focusing on your breathing can help you manage the pain.

Water

Even if you don’t want to give birth in water, spending some time in a shower or bath can help relieve the pain of childbirth.

Being in water has been found to be particularly effective in the first stage of labor. It can help relieve both pain and anxiety. If you have access to a moveable showerhead, aiming warm water directly onto the lower back may feel especially pleasant.

Massage and counterpressure

Many different types of massage can help manage pain during labor. Foot, hand, back, and shoulder rubs may all appeal to you. One study from 2010 found that a 15-minute massage each hour during labor helped alleviate pain and was even associated with shorter labor.

Additionally, perineal massage can help protect and prepare the perineum for the stretching involved in birthing a baby.

In addition to massage, many women enjoy pressure being strategically placed on parts of their body to help counteract the discomforts they may be feeling.

Music

Music can lower stress and blood pressure. It can also improve your mood! But can it really help with pain during labor? Yes — a large meta-analysis found that music interventions helped alleviate pain and anxiety during labor.

Visualization or hypnosis

Guided imagery, hypnotic tracks, and other visuals can all help relax a mother in labor and relieve pain.

Movement

Walking, rocking on a birthing ball, or even slow dancing with your partner can help labor progress and relieve some of the discomforts you may be feeling.

Experimenting with different positions, including sitting, standing, or squatting, may also help reduce pain. One study found squatting offered the most pain reduction, but you can experiment with what feels best for you.

A doula

Research shows that having a doula present at your birth can lead to a better birth outcome. A doula can help with positioning/counterpressure, offer suggestions for comfort measures, advocate for your choices, and help answer your questions throughout the laboring process.

Not sure where to find a doula? Start here.

A TENS unit

Many people have found some pain relief during labor by stimulating their lower back with a transcutaneous electrical nerve stimulation (TENS) unit. (Some hospitals even have TENS devices that you can borrow during labor!)

Aromatherapy

If you’re feeling nauseous or anxious, peppermint, lavender, or some citrus essential oils may provide some relief during labor.

IV narcotics

Intravenous (IV) narcotics offer some of the pain relief of an epidural for a more limited time. As in the case of an epidural, nausea, headaches, drowsiness, and the transmission of medication to the baby are potential risks.

For a woman seeking a brief reprieve from the intensity of birth, an IV narcotic can be a very appealing pain relief option.

Nitrous oxide

While you may have seen it during dental visits, in the United States nitrous oxide is less commonly used as a pain relief option during childbirth. It’s a fast-acting option for pain and anxiety relief that doesn’t stay in the system as long as narcotics.

Nitrous oxide has been used for over a century and is generally considered safe for the mother and baby. While it’s used regularly in some locations around the world, you’ll need to check with your provider as to whether it’s available where you’re delivering.

Epidural

The most common pain medication for birthing mothers in the United States, an epidural can relieve the pain a mother is feeling within 10 to 20 minutes. Most hospitals provide epidural analgesia, and if your pain is beyond a manageble level, you can request one.

The vast majority of women who receive an epidural feel pressure and not pain from that point on in their labor. (Many women can even sleep while laboring once the epidural has been placed.)

There’s some risk that an epidural will result in a specific type of headache, pushing may be more difficult, your lower half may remain numb for a period of time after giving birth, or you may react to the medication used in the epidural. Still, many women find that the pain relief an epidural offers outweighs these risks.

There’s no way to know exactly what childbirth will be like for you. Even if you have given birth before, each experience is different. Taking steps to prepare beforehand and using comfort measures during labor can reduce the pain of childbirth.

There’s no reason to be fearful about giving birth. While it’s called labor for a reason, millions of babies are born each year. You’re not alone! Your care provider can work with you to ensure that you have the medication and holistic pain reduction measures you need to handle your contractions.

Is giving birth painful?

Childbirth is a natural physiological process that is inevitably associated with pain. Prolonged pain tires a woman, leads to a violation of the contractile activity of the uterus and can adversely affect the course and outcome of childbirth, and most importantly, the health of the mother and child. Therefore, pain relief is very important!

In our maternity hospital, we use the most modern and gentle methods of labor analgesia.

The most common methods of labor pain relief in Russia are the use of narcotic analgesics and epidural analgesia.

Intravenous or intramuscular injection of a narcotic analgesic is usually used in the early stages of labor or during labor precursors to give a woman an opportunity to rest and gain strength. A narcotic analgesic can cause drowsiness in a woman in labor and depression of consciousness and breathing in a child, so its administration is not recommended in the later stages of childbirth.

Epidural analgesia is the most effective and safe method of labor pain relief:

it makes it possible to eliminate pain throughout childbirth and saves the woman strength and emotions to meet the baby;
better than other methods of anesthesia, it allows you to fulfill the requirement for careful management of childbirth and turns childbirth into a less traumatic process for the fetus and mother;
reduces pain sensitivity in the lower parts of the body, but does not affect the consciousness and mobility of the woman in labor;
contributes to the normalization of labor activity in case of its violations;
allows you to anesthetize the closure of tears and abrasions of the tissues of the birth canal after childbirth without the use of anesthesia;
if the birth plan changes and there is a need for a caesarean section, anesthesia is continued by the same safe method, which allows the woman to be conscious and communicate with the baby from the first minutes of his life.

What is the essence of the method of epidural analgesia?

The anesthesiologist, painlessly for the woman in labor, inserts a special sterile thin catheter between the vertebrae into the space in front of the membrane surrounding the spinal cord. Nerve roots pass through this space, through which pain impulses from the contracting uterus enter the spinal cord, and from there to the brain with the formation of a sensation of pain. An anesthetic solution, a local anesthetic, is injected through the catheter to block the nerve roots and interrupt the flow of pain information during childbirth.

Does epidural analgesia affect the fetus?

Epidural analgesia is safe for mother and child - this has already been proven by many modern studies. Moreover, effective pain relief not only increases the comfort of a woman during childbirth, but also normalizes blood flow in the placenta, which in turn helps prevent oxygen deficiency in the fetus. A number of clinical studies show that with anesthesia with modern local anesthetics, instrumental delivery is used less often, and newborns have better scores on rating scales.

Childbirth. Painful and scary? No pain and no fear!

My charming beloved daughter is two years old. Two years of great happiness from communicating with this miracle, two years in the world of absolutely new and wonderful emotions... And over the years, I regularly remember my pregnancy, the moment of the birth of my girl and the feelings that overwhelmed me then. I would like to share my personal experience of natural childbirth and thoughts that probably come to the mind of all expectant mothers, and especially those who are expecting their first child.

Starting from afar, I will say that I have a very low pain threshold, I can not stand any medical manipulations. In general, until the age of 25 (I gave birth at almost 29), the thought that I would someday have to give birth (and I always wanted a child) caused me horror and tears in my eyes. From my youth I was interested in medicine and re-read quite a lot of literature and articles from the Internet about childbirth long before pregnancy. I was just curious. And films with a standard image of childbirth complemented the already “colorful” picture: an operating room, screams, groans, inhuman torments, fussing doctors ... At that time, I saw childbirth as a test that had to be heroically passed. After reading stories about childbirth, I had the feeling that in the maternity hospital the main person in childbirth is a doctor who necessarily performs some kind of manipulation (“pierced the bladder”, “put an epidural”, “finally injected painkillers”, etc. .). At the same time, questions were spinning in my head: “How did they give birth before in villages with midwives without anesthesia? And how do the medicines that a woman is stuffed during childbirth affect the child and milk?

Once again, surfing the Internet, I came across excerpts from Michel Auden's book "Reborn Childbirth", which turned my idea of them upside down and answered many questions. I fully agreed with the author, who wrote that childbirth is a natural process, and the main character in them is a woman who, it turns out, is able to give birth herself, you just need to give her this opportunity. Auden's ideas inspired me, but I understood that France is France, and I would have to give birth in a Russian maternity hospital (the prospect of home birth did not attract me), where they would hardly be reverent about my wishes ...

I get the good news that my husband and I are expecting a baby! I began to look for a medical center where I could be observed during pregnancy, and I came to the Center for Traditional Obstetrics for information, where I learned about the Natural Birth program. To be honest, I have never even heard of such a “golden mean”, as I see it now, between standard and home births. The decision on where to give birth was made by me intuitively. I immediately felt that this was mine, that I had a chance to give birth on my own, as it was provided by Nature, which I really wanted.

Many people think that there is no reason to go to the courses, that you can read books and magazines, and everything that is taught in the courses will be forgotten at the time of childbirth anyway. Of course, this is everyone's choice. I believe that preparation for childbirth and courses for pregnant women are absolutely inseparable things. No books will tell what a practicing obstetrician will tell, they will not answer exactly your question. Personally, the courses have helped me a lot. Classes dedicated to childbirth radically changed my idea of labor pain, I realized that you should not be afraid of it, but you need to learn to accept it, not by clenching your teeth and clenching your teeth, but by relaxing, no matter how paradoxical it sounds. A film about childbirth (where none of the three women screamed in pain) finally convinced me that there is nothing terrible in this process. The most valuable result of the courses for me was that I became psychologically ready for childbirth. And as we all know, a lot comes from the head and inner mood. In the courses, we did not memorize breathing exercises, relaxation exercises, we were simply shown positions in which it might be convenient to endure contractions, explaining that during childbirth the body itself will tell you how comfortable it is in this or that period - and so it turned out in fact, or something the midwife will advise. After the baby was born, the information received in the classes, where they talked about breastfeeding, caring for the baby, and the physiological characteristics of newborns, helped me a lot. I felt confident and knowing what to do with my own child.

The Natural Birth program provided for several visits to the midwife who will take care of the birth, even two - the main one and the "backup". It was very important for me to be next to the person taking delivery, whom I already know, who sees you not for the first time, and in a place familiar to me (when concluding a contract in the maternity hospital, they showed me the ward where the birth takes place). For each visit to the midwife, I prepared a whole list of questions, and not only related to childbirth. Together we adjusted the list of things that you need to take with you to the hospital, the list of “dowry” for the child at home, several times we talked about the action plan when I understand that “something is starting”.

...The birth began, as is often the case, at night. I felt my stomach begin to pull, but I decided that these were training contractions, which I had been waiting for. My husband advised me to call the midwife, but I decided not to disturb her at 12 midnight. Three hours later, I realized that this was no longer a “training” and called. The midwife arrived 40 minutes later, looked at me and said that you can go to the hospital. At the maternity hospital, I really appreciated the joint visit with the midwife, who saved me from standard unpleasant procedures (in my case, the body cleansed itself at home). My husband left (it was our mutual decision that I would give birth without him), and I stayed with the midwife. How grateful I was to Larisa for being by my side all the time! She suggested comfortable positions for me, gave me water to drink, poured a bath in which it was much easier for me to endure the contractions that were already very strong by that time, and at the same time she was, as it were, invisible. Almost all births we were with her together. The maternity hospital doctor came in the first time for a minute right after we settled in the ward, and the second time - at the last attempts, although, to be honest, her presence bothered me because her mobile phone constantly rang, and this, believe me, in such a crucial moment is very annoying.

The labor itself (pulling) lasted almost two hours. As I now understand, in the maternity hospital they would hardly have bothered so much with me in the birth chair (and I wouldn’t have lasted there for so long). And the midwife waited patiently, periodically checking the baby's heartbeat, and encouraged me, saying that everything was in order.

Being attuned to childbirth without anesthesia, but knowing my inability to endure pain, before childbirth, even after the courses, in the depths of my soul I asked myself the question: “When will I still scream that I can’t take it anymore and demand anesthesia?”. Anesthesia was not required! At some moments it was more difficult than unbearably painful, it was physical fatigue at the end of the contractions (at that moment I said the only time: “I can’t take it anymore! I’m tired.” But the midwife explained to me that the contractions were about to when they run out, and it becomes easier.This gave me new strength, and, indeed, after a couple of minutes they ended.

And then my baby was born! She didn't scream, but groaned calmly. The pediatrician immediately came to examine her, because. she had an umbilical cord around her neck, but everything was fine with her, and a minute later my daughter was placed on my chest! I did not cry with happiness (although before the birth I imagined this moment in this way), but lay and enjoyed the inexplicable calmness, stroking my baby. An hour later my husband arrived, and we were all together until evening.

Someone says that it is boring to lie in a separate room, that two or four people are more fun, but personally I didn’t need any communication, except communication with my own child! And it is much more convenient to receive relatives in a separate room.

The maternity hospital offered to take the baby for the night, I refused (but the nurses did not insist, they just said that if I wanted, I could give her at any time), because. I couldn't imagine my life without my baby. Before giving birth, many people told me that I needed to “rest,” that I would recover more slowly if I took care of the child myself from the first hours. But I initially had a mindset to be with the baby. Yes, I felt tired after giving birth, I sincerely envy those mothers who, a couple of hours after giving birth, were already ready to fly! This was not my case, I felt weak, “broken” all over my body, but in the first seven hours, the presence of my husband helped me a lot. From my experience, I can say that the best rest for a mother is to lie next to a sleeping baby. If the baby feels good and comfortable (again, with a mother nearby), then at first he sleeps a lot and lets him sleep and rest. And if something worries him, then his mother - her voice, hands, smell - is needed even more (of course, we are not talking about conditions requiring urgent medical intervention). Performing simple procedures - feeding, changing clothes - naturally makes you get out of bed and move. There was a very friendly staff in the maternity hospital No. 6, they showed me several times at my request how to swaddle and wash the baby, they answered all my questions. I don’t even talk about the role of living together in establishing breastfeeding, because. it's just obvious.

My baby girl was very calm from birth, she hardly cried, I think that this is partly because she was allowed to be born on her own. And I had a very good impression from the birth, a feeling of well-done responsible work. I remember a funny moment when already at the last attempts (!!!) for some reason the thought occurred to me that in French and English the word “work, labor” (travail, labor) also means “childbirth”. I told the midwife and the doctor about this, they looked at me with surprise, because, apparently, for the first time they encountered the fact that a few minutes before the birth of a child, a woman discusses philological nuances with them, but agreed with me. Childbirth really requires the active participation of a woman, her work with her own body, labor pain.

There is an opinion that labor pain is quickly forgotten, because she is overwhelmed by the joy of having a baby. But I remember all my feelings very well and from my own experience I can say that there is no unbearable pain in childbirth. Many of my friends, hearing from me that I gave birth without stimulation, without anesthesia, and at the same time did not experience unbearable pain, unfortunately, they are sincerely surprised, and sometimes they do not believe.