Dealing with Pain During Childbirth

Pain is a part of the labor process. It occurs because of the things your body must do to give birth to a baby. First, your cervix softens and opens. Then, your uterus contracts to push the baby out. Finally, your birth canal and vagina stretch to allow the baby to exit. Everybody can handle a certain level of pain. But everybody reacts to pain in different ways. This means your labor process will differ from someone else’s.

Path to improved health

How you want to deal with childbirth pain is an important decision. You will work with your obstetrician (OB) doctor and and possibly an anesthesiologist (pain) doctor to develop a plan to manage your pain. They will talk with you about options and provide recommendations. You should create a pain plan with them early so you’re prepared and know what to expect. If you have a high-risk pregnancy, this will play a part in how your pain is handled.

You can choose to deal with childbirth pain in a natural way or by using medicine. Most people do a mix of both. Talk with your doctor to weigh all the factors of managing pain.

Natural way

If you choose the natural way, you won’t receive any pain medicine. You will still receive medical care, but you will rely on natural methods to manage your pain. These include special breathing techniques and other approaches. You may want to plan for exceptions to get medicine if problems occur. It’s okay if your initial plan for a natural childbirth changes and you end up wanting pain medicine.

Natural birth methods include:

• Lamaze: This is the widest known and practiced method. It often is taught in birthing classes you take before delivery. It involves ways to relax your body and mind when you’re having pain. These include breathing exercises, forms of distraction, and massage. Lamaze is done with the support of a coach, who can be your partner or another person. You can combine this technique with medicine if you choose.
• Bradley method: This approach focuses on a healthy, active pregnancy and mental rest in labor. This practice only believes in natural childbirth and can’t be used with medicine. There can be an exception for serious problems.
• Waterbirth and HypnoBirth: These are two other natural approaches that are becoming more popular. Some women consider water to be a relaxing setting and more natural entry for the baby. Little research exists on the safety and value of this approach. HynpoBirth focuses on a state of mind where childbirth is painless. It teaches you how to detach from the fear of labor and have a calm childbirth.

Additional natural things you can try to deal with pain include:

• Changing positions
• Going for a walk
• Massage
• Yoga or stretching
• Using a heating pad or cool towel
• Taking a bath or shower
• Listening to music
• Meditation or visualization

Anything else that helps relax or distract you

Medicine

There are two main types of pain medicine you can get while you’re in labor. Anesthetics help block, or prevent, pain. Analgesics help relieve pain. With either form, it’s likely you still will have some pain before, during, or after childbirth. Not everyone qualifies for medicine based on their current medical condition.

There are three types of anesthesia you may receive:

Regional anesthesia: This type of treatment affects a region of your body. It can be used if you’re having a vaginal birth or C-section. Regional anesthesia can include:

• An epidural block is the most common form of medicine used today during childbirth. A doctor injects medicine into the spinal fluid in your lower back through a thin tube (catheter). It blocks the nerves that travel from your spine to the lower half of your body below the belly button. The doctor releases the desired amount of medicine through the epidural, which mostly numbs the affected area.
• A spinal block is like an epidural, except medicine is injected through a needle instead of a catheter. Spinal blocks are not common practice in childbirth.
• A combined spinal-epidural (CSE) block is when you get both a spinal block and an epidural.

Local anesthesia: This type of treatment numbs specific areas, such as the uterus, vagina, or abdomen. One example is a pudendal block, which helps numb the area around your vagina and anus. You receive this form of medicine right before delivery if you’re having a vaginal birth or C-section.

General anesthesia: This type of treatment affects the nerves in your whole body. You won’t have any pain because it puts you to sleep. A doctor would primarily use this in emergency c-sections when there is a medical issue with you and/or your baby.

Analgesics are opioids (narcotics) that help reduce pain. They can be given locally or regionally through a shot or IV (intravenous). This pain medicine can produce side effects, such as making you tired, nauseated, or light-headed.

Things to consider

While you and your doctor can develop a plan, keep in mind that plans can change based on pre-labor and labor. Factors include your baby’s size and position, your physical and emotional state, and the labor process (if it’s moving fast or slow). It also depends on if you’re having a vaginal delivery or cesarean delivery (C-section). A C-section is surgery to remove your baby through an opening in your uterus and abdomen. Also, it’s possible to receive more than one form of medicine throughout the labor process.

The plan you develop with your doctor should give you an idea of what to expect during labor. For instance, many medicines need to begin prior to active labor, or pushing. You also should have a backup plan with your doctor in case problems occur. Remember medicines wear off over time, so talk to your doctor about how to treat ongoing pain if your labor is long.

Any medicine you take during childbirth will also go to your baby through the umbilical cord. Some forms of pain management can have a negative effect on your baby. Be sure to discuss the pros, cons, and effects of each type of pain medicine with your doctor in advance.

Questions to ask your doctor

• What is the best pain management approach for my situation?
• At what stage during my pregnancy should we discuss pain management techniques?
• Are there exercises I can do during pregnancy to prepare me for pain during childbirth?
• How early in labor do I need pain medicines, like an epidural?
• Is there a time during labor it becomes too late to have pain medicine?
• What are the potential side effects of medicine for my baby and me?
• Will I be able to move, feel, eat, or drink if I get medicine?

Resources

U.S. Department of Health and Human Services, Office on Women’s Health: Labor and Birth