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Is it painful giving birth


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.

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Dealing With Pain During Childbirth (for Parents)

Learning all you can about labor and delivery is one of the best ways to help you manage the pain of childbirth when the time comes.

Pain During Labor and Delivery

Pain during labor is caused by contractions of the muscles of the uterus and by pressure on the cervix. This pain can be felt as strong cramping in the abdomen, groin, and back, as well as an achy feeling. Some women experience pain in their sides or thighs as well.

Other causes of pain during labor include pressure on the bladder and bowels by the baby's head and the stretching of the birth canal and vagina.

Pain during labor is different for every woman. It varies widely from woman to woman and even from pregnancy to pregnancy.

It's often not the pain of each contraction on its own that women find the hardest, but the fact that the contractions keep coming — and that as labor progresses, there is less and less time between contractions to relax.

Preparing Yourself

To help with pain during labor, here are some things you can start doing before or during your pregnancy:

Regular and reasonable exercise (that your doctor says is OK) can help strengthen your muscles and prepare your body for the stress of labor. Exercise also can increase your endurance, which will come in handy if you have a long labor. The important thing to remember with any exercise is not to overdo it — and this is especially true if you're pregnant. Talk to your doctor about what he or she considers to be a safe exercise plan for you.

If you and your partner attend childbirth classes, you'll learn different techniques for handling pain, from visualization to stretches designed to strengthen the muscles that support your uterus. The two most common childbirth philosophies in the United States are the Lamaze technique and the Bradley method.

The Lamaze technique is the most widely used method in the United States. The Lamaze philosophy teaches that birth is a normal, natural, and healthy process and that women should be empowered to approach it with confidence. Lamaze classes educate women about the ways they can decrease their perception of pain, such as through relaxation techniques, breathing exercises, distraction, or massage by a supportive coach. Lamaze takes a neutral position toward pain medicine, encouraging women to make an informed decision about whether it's right for them.

The Bradley method (also called Husband-Coached Birth) emphasizes a natural approach to birth and the active participation of the baby's father as birth coach. A major goal of this method is the avoidance of medicines unless absolutely necessary. The Bradley method also focuses on good nutrition and exercise during pregnancy and relaxation and deep-breathing techniques as a method of coping with labor. Although the Bradley method advocates a medicine-free birth experience, the classes do discuss unexpected complications or situations, like emergency cesarean sections.

Medicine-free ways to handle pain during labor include:

  • hypnosis
  • yoga
  • meditation
  • walking
  • massage or counterpressure
  • changing position
  • taking a bath or shower
  • listening to music
  • distracting yourself by counting or performing an activity that keeps your mind otherwise occupied

Pain Medicines

A variety of pain medicines can be used during labor and delivery, depending on the situation. Many women rely on such medicines, and it can be a huge relief when pain is quickly eased and energy can be focused on getting through the contractions. Talk to your health care provider about the risks and benefits of each type of medicine.

Analgesics. Analgesics ease pain, but don't numb it completely. They don’t affect sensation or muscle movement. They can be given many ways. If they are given intravenously (through an IV into a vein) or through a shot into a muscle, they can affect the whole body. These medicines can cause side effects in the mother, including drowsiness and nausea. They also can have effects on the baby.

Regional anesthesia. This is what most women think of when they consider pain medicine during labor. By blocking the feeling from specific regions of the body, these methods can be used for pain relief in both vaginal and cesarean section deliveries.

Epidurals, a form of local anesthesia, relieve most of the pain from the entire body below the belly button, including the vaginal walls, during labor and delivery. An epidural involves medicine given by an anesthesiologist through a thin, tube-like catheter that's inserted in the woman's lower back. The amount of medicine can be increased or decreased according to a woman's needs. Very little medicine reaches the baby, so usually there are no effects on the baby from this method of pain relief.

Epidurals do have some drawbacks — they can cause a woman's blood pressure to drop and can make it difficult to pee. They can also cause itching, nausea, and headaches in the mother. The risks to the baby are minimal, but include problems caused by low blood pressure in the mother.

Tranquilizers. These drugs don't relieve pain, but they may help to calm and relax women who are very anxious. Sometimes they are used along with analgesics. These drugs can have effects on both the mother and baby, and are not often used. They also can make it difficult for women to remember the details of the birth. Discuss the risks of tranquilizers with your doctor.

Natural Childbirth

Some women choose to give birth using no medicine at all, relying instead on relaxation techniques and controlled breathing for pain. If you'd like to experience childbirth without pain medicine, discuss this with your health care provider.

Things to Consider

Here are some things to think about when considering pain control during labor:

  • Medicines can relieve much of your pain, but probably won't relieve all of it.
  • Labor may hurt more than you expected. Some women who had said they want no pain medicine whatsoever end up changing their minds when they're actually in labor.
  • Some medicines can affect your baby, making the baby drowsy or causing changes in the heart rate.

Talking to Your Health Care Provider

You'll want to review your pain control options with the person who'll be delivering your baby. Find out what's available, how effective they're likely to be, and when it's best not to use some medicines.

If you want to use pain-control methods other than medicine, make sure your health care provider and the hospital staff know. You might want to also consider writing a birth plan that makes your preferences clear.

Remember, many women make decisions about pain relief that they abandon — often for very good reason — at the last minute. Your ability to endure the pain of childbirth has nothing to do with your worth as a mother. By preparing and educating yourself, you can be ready to decide what pain management works best for you.

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 child for the night, I refused (but the nurses did not insist, they simply 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.

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