By

“I couldn’t put in my mind what pain I would suffer. It was the worst pain I’ve ever had in my life. I can see the pain you know. Not feel it, I can see it.” (Laura)

“I just feel so empowered, so strong, so amazed that my body could…well yeah, just follow its instincts so utterly, so exquisitely-to just know what I needed to do. It’s like a reference for me in my whole life of the fact of how much I’m capable of.” (Kerry)

What makes these two women tell such different birth stories? Both had normal births and experienced labours of a similar length. Laura had drugs for pain and Kerry gave birth in the water without any drugs. One was traumatised and one was triumphant. English was not Laura’s first language. During labour she was largely left alone. When she finally gave birth she describes the experience as, ‘surrounded by strangers’. Laura had no idea what to expect. She never read a book on pregnancy or went to antenatal classes. Kerry on the other hand researched all her options and, as she says, read every book she could get her hands on. She had a midwife she knew for all her care, antenatal, birth and postnatal. She gave birth in the water, at home with great support people and felt in control of the whole experience.

Giving birth is about more than just the physical act of giving birth, it involves our minds, our hearts and our bodies.

The horror stories

“Awful! I really expected it to be extremely painful because mum said her labour was twenty- three hours for her first, which was me, and I was really scared. But it wasn’t as bad as I thought it was going to be.” (Sarah)

We have all heard the labour horror stories that for some reason women are compelled to tell each other-as though each has to outdo the other in surviving the world’s most traumatic birth. Sadly what women are less compelled to talk about is the sense of triumph and accomplishment they can feel having given birth without having to resort to pain relief drugs.

Fear about the pain of labour and birth frequently occupies a pregnant woman’s thoughts. Women may worry about what the pain will feel like, whether they will cope with it and how others will view them if they don’t cope.

In most areas of our lives pain is seen as a negative, frightening experience. Pain often alerts us to the fact that something is wrong with our bodies so it is natural to fear it. We are quick to try and relieve pain and treat the cause of pain, and indeed see the ability to do this as one of the benefits of living in an advanced, modern society. In childbirth, however, the majority of labour pain is the result of a normal, physiological process.

Why does labour hurt?

Pain in labour is a very complex combination of physical and psychological factors. Labour pain comes from the uterus, cervix, pelvic joints and ligaments. During the actual birth pain comes from the vagina and perineum stretching to accommodate the baby’s emerging body. Pain is transmitted to the brain by nerves in the middle and lower back. When it comes to the pain of labour, Mother Nature has not left us without assistance.  As labour progresses endorphins (natural drugs) in the body begin to rise, making the pain easier to cope with. They can also make women feel a little spaced out and detached from their surroundings. They disappear within themselves to a quiet space where all women hide their amazing strength.

“I sort of wasn’t aware of where I was and what was happening. I mean everything around me was really quite oblivious and I was just so focussed on myself and the baby.” (Tracy)

Does the pain have a purpose?

Some women experience no pain when in labour or labour very fast and whilst we may consider them very lucky they can actually give birth very suddenly and be completely unprepared for it. It can be risky for both the mother and baby.  The pain of labour makes us prepare ourselves and seek out support and safety when we give birth. It is pain ‘with a purpose.’

“Sometimes I think if the labour hadn’t been so fast I wouldn’t have had this terribly bewildered feeling afterwards. I was just overwhelmed at the fact, there she is.” (Sarah)

Does everyone experience the same pain?

There are many factors that influence our perception of pain and make labour an unbearably painful experience for women like Laura and a powerful triumph for women like Kerry. Fear and anxiety can greatly influence the perception of pain. When women are anxious they produce adrenaline, which inhibits the production of endorphins. This leads to women experiencing increased pain and also being less able to cope with it.

“It was like and alien had taken over your body. I was dreading every contraction.” (Faith)

Pain is greater if the baby is in an abnormal position, such as in a posterior position, where the back of the baby’s head presses into the mother’s spine.  Other factors such as cultural background, personality, expectations and lack of sleep, also mean that each woman will have her own unique experience of pain.

Can support make pain easier to cope with?

“She[midwife] was fantastic and she was the one who gave me every opportunity and honoured me to do exactly what I wanted to do to deliver my baby. I felt empowered, I felt supported and I felt I was actually in control.” (Wanda)

The quality of the support people women choose to be present at their births, and being cared for by midwives they get to know during the pregnancy, can affect the type or amount of pain relief needed. Research demonstrates that the presence of good support in labour reduces all forms of intervention, including a reduced need for pain relief such as epidurals and pethidine. This results in fewer women viewing their labours as negative and leading to feelings of greater satisfaction and control during the labour.

Research into women’s perceptions of labour pain after birth has shown no difference between groups of women that used very basic pain relief, such as Kerry, and those who used high levels, such as Laura.  Many women regarded the pain of labour in a positive light, as a feeling of achievement, and this supports the view that having a less painful delivery does not ensure a more positive birth experience. Other studies have demonstrated that women who report the most pain are more anxious during labour, expect to have a lot of pain and lack support from their midwife. They also tended to have long lab