Many women tell me that their top fear when it comes to birth is the pain. Everything we are told in movies, TV and often from friends and family focusses on the pain of birth, but what if we reframed it to something more positive?
I think the first step to working with pain in labour is understanding exactly what is happening during a contraction. A contraction occurs in the uterus or womb. During your pregnancy your uterus is growing from about the size of a pear (pre-conception), into a very large muscle that houses your baby. When your body releases the labour hormone oxytocin, this causes the uterine muscles to contract. During a contraction the circular muscles at the neck of the womb are stretched open by the longitudinal muscles. Over time, this allows the cervix to become fully dilated (or open), and also assists in moving your baby down the birth canal.
I want you to remember that a contraction is just a muscle working. It is a good thing that is bringing you closer to meeting your baby. Without contractions we wouldn’t have any babies born naturally. It’s important that we embrace contractions as the good thing that they are!
When your labour starts it is likely to feel like a tightening sensation or period cramp in your tummy or lower back. Contractions can be quite sporadic to being with, and may only last a short period. In time, your contractions will become stronger (lasting around 60-90 seconds) and will also settle into a regular pattern. This means that your body will have a contraction, and then the uterus muscles will relax, and you will have a break before the next one begins.
In early labour it is important to chill out and relax. Your body is doing lots of good work, and most women are most comfortable if they can stay at home until their contractions are coming every 3-5 minutes, and lasting around 60 seconds. You could try a warm shower or bath, massage, TENS machine, hypnobirthing techniques, and gently swaying during your contractions. You can always contact your midwife or doctor if you are unsure of when you should head into hospital. They are there to support you and a phone conversation with your midwife can be a wonderful reassurance in early labour.
Remember that your hormones are also helping you in labour. Not only is the oxytocin telling the uterus to contract, it is also having a calming and pain relieving effect on your brain. Pretty clever! During labour women also release endorphins, which are our bodies natural pain relief. In unmedicated labour, endorphins continue to increase as labour progresses. Unfortunately if women feel stressed or anxious during labour their body will likely have high levels of the stress hormones adrenaline and noradrenaline, which can actually inhibit oxytocin. This is why it is really important to stay as calm and relaxed as possible during your labour.
Having a known care provider can also help you to feel safe and supported. Research has shown women who receive care from a known midwife during their labour are less likely to use pain relief such as epidurals or other drugs. Midwifery continuity of care refers knowing your midwife - being cared for by, and able to build a relationship with the same midwife or group of midwives during pregnancy, through labour and birth, and into the early weeks of becoming parents. A woman who receives care from a known midwife is also more likely to have a normal birth and a more positive experience of labour and birth. There are many ways to access midwifery continuity of care – through a midwifery group practice or caseload program through your public hospital, a private midwife, or a birth centre where midwives work in a team.
For many women the term ‘contraction’ brings up many feelings of pain and anxiety. You may like to use a different word like ‘surge’ or ‘wave’ to describe the contraction, as this can help you to see your contractions as more of a muscle working, rather than something negative or to be avoided. The words and language that we use is really important when it comes to labour and birth.
Labour pain is nothing to be fearful of. For many women, the natural hormones in labour allow them to manage the intensity of their contractions beautifully - I’ve even had many of my hypnobirthing clients tell me that their labour wasn’t really that painful! With the right support, preparation and trust in your body, birth can be an incredible experience! In Australia we have many medical pain relief options available to use if required, so you can always opt for one of these if you choose during your labour. I want all women to go into their labour and birth feeling prepared, confident and not scared at all! Giving birth to your baby truly can be an incredible experience!
Article written by PBC Expo Midwife Hannah