Pain in Childbirth

Giving birth is a painful process. For many women childbirth is a frightening experience and it is only natural for a birthing mother to voice her concerns.  Fear is an important factor of childbirth. Even in the scriptures childbirth is portrayed as involving hard labour and pressure. Childbirth is a unique pain at a deeply emotional time for women. The pain in labour is the result of many complex interactions, physiological and psychological, excitatory as well as inhibitory.

We ask the question why there is pain during childbirth. Pain is the psychological, emotional and learnt response to signals induced by noxious stimuli sent from around the body via the spinal cord, to the brain. How we react to them and perceive them is what we feel as pain. But pain in labour is a normal physiological reaction. It is normal to have pain in childbirth and there for a reason for it. In an uneventful pregnancy, labour, pain can be used in a positive manner. But women react against the pain by becoming tense and fighting it. Labour pain is positive pain that will have a positive end-the baby. Labour pain is not like cancer pain that never goes away. Nobody has been in labour forever, so the pain will go away. The pain of each contraction will not be experienced again when it passes.

We know that labour pain is difficult to explain. Labour pain is the result of many complex interactions, physiological and psychological, excitatory as well as inhibitory. Pain during the first stage of labour is due to distention of the lower uterine segment, mechanical dilatation of the cervix and lastly due to stretching of excitatory nociceptive afferents resulting from the contraction of the uterine muscles. The severity of pain parallels with the duration and intensity of contraction. In the second stage additional factors such as traction and pessure on the parietal peritoneum, uterine ligaments, urethra, bladder, rectum, lumbosacral plexus, fascia and muscles of the pelvic floor increase the intensity of pain.

The McGill Questionnaire describes it best. The McGill Pain Questionnaire consists of groupings of words that describe pain. The person rating their pain ranks the words in each grouping. The sensory words most commonly used by mothers to describe the pain during labour are sharp, cramping, aching, throbbing, stabbing, hot, shooting, tight, and heavy. For the emotional affective feelings, the most common words were tiring and exhausting.  

Also each woman has different reactions towards labour pains. Pain relief can come in many forms. Most importantly, a support person who believes in the laboring woman can make a difference. Several studies have shown that good labour support reduce the fear and anxiety during childbirth.

Each woman has different reactions to pain, so pain relief should be individualised and not a routine offer from a list. Most pain relief does not take pain away as completely as the name suggests. It makes pain easier to accept and can help a woman relax and concentrate on the birth if it is used positively. Pain relief can come in many forms. Good nutrition, comfortable position, mobility, and feeling supported-all can be pain relievers.