For centuries, people didn’t have drugs & coped beautifully with labour, because they understood the other things that could make the experience more manageable.

If you want your labour to be as drug-free as possible, understanding this has to be your starting point.

And quite rightly so. In terms of medical research, it’s a generally perceived truth that ‘labour pain is one of the most severe pains which has ever been evaluated’ (Beigi & Broumandfar et al, 2010), an idea which has become strong within our society. 

I am not going to tell you that labour isn’t painful. The physical - dare I say ‘mechanical’ - elements of birth (the contractions, the dilation, the pushing, the stretching etc) are all intensely physical and can be painful. Really bloody painful.

But this is where science and popular belief start to separate: because while the general population prepare themselves for constant extreme levels of pain, research recognises that this is not always the case. 

There is no universal measurement for labour pain, so there’s no singular way of knowing exactly what labour feels like for one person in comparison to another; everything is based on what people tell us about how they feel during their labours. But what we do know is that there are a huge number of variables which influence how individuals will feel and cope with the sensation of labour.  

So when people ask me how they’ll cope with the pain of childbirth, we don’t start with mechanics.

We start with the variables.

While ‘women usually experience[d] severe pain and various degrees of anxiety’ they are also often ‘felt greatly involved with the birth process (and) were satisfied with their own achievement’. This is not knew knowledge: anyone who has ever given birth or witnessed birth for the whole of human existence could tell you that.

But that doesn’t make it any less confusing: how can something be awful and brilliant at the same time? 

But this just proves the point: when it comes to labour pains, it’s not always about the sensation itself, but how we view it and ourselves. While our ancestors knew this, and their social structures were set up to give expectant mothers this, our world of ‘distanced birth’ isn’t'; as birth moved into the hospital and away from the home, the knowledge of how a physiological and supported labour progresses - and how best to cope with it confidently - has been lost, and has become just a physical, medical act.

But just because we think that way, doesn’t mean it is that way. Or that it has to stay that way.

Planning to cope with labour pain is less about the physical act of the labour that our bodies are doing, and far more about understanding what’s going on around it at the time that can make everything better:  

• The way we are supported: the more sensitive our birth partners and midwives are to our needs, the more able to cope with extreme pain we are.  

• The length of our labours: the more effective, enjoyable and shorter our labour is, the more able we are to tolerate the pain we experience during it. 

• Our initial expectations: the more realistic we are about how we individually experience pain, and what we will need to cope, the better we will cope. 

• Our role in our own labours: how active, proactive and decisive we feel about the progression of our labours, affects how well we can cope with the pain of labour. 

When any or all of these elements are on the negative side (eg: a very long labour, where we feel anything we do or have chosen is not working) it’s far more common to see people struggling with the sensations of labour. 

But on the other side of that, where these elements are harnessed in a positive way (support is active and sensitive, methods are used to support effective contractions and the birthing person feels in control of everything etc), then it is far more usual to see people managing to cope with even the most severe levels of pain during childbirth.   

The easiest way to do this is to explore four areas honestly and without judgement of yourself or others.

1. SUPPORT: Who do you need on your birth team? 

Who can look at you and know what you need? Who can keep you confident and positive? How do you trust to tell you the truth and keep you focused.  

2. PROGRESS: How can you keep labour progressing well? What positions, movements, environment, food and drink are you going to use to keep everything running as well as it can. 

3. SELF-MANAGEMENT: How do you cope with pain, like a stubbed toe, now? Do you need distraction or to sit with it? Does movement and vocalisation help you? Does counting or focus or visualisation help you? 

4. FEAR: What are you scared of? How much do you know about what your body will do, how it will do it, why it’s doing it and for how long? What about this scares you and how can we make it less scary before and during labour?

The answers to all of these questions will help you to identify two thing: what will increase your pain, and what will reduce it.

For example: for your birth partners. Yes, you love your mum and husband, but when you stub your toe they wind you up by being too cuddly. But your best friend Linda, she knows that the best strategy is to leave you be and then, when you look right, to crack a joke. Perhaps Linda needs to be on your birth team.

Just saying…

Your birth is your story: how you choose to approach pain management is absolutely up to you. 

BUT there’s a difference between choosing a path because we feel scared and doubt whether we can’t cope with the alternatives, and choosing a path because we’re confident it’s the one that’ll help us to cope best. 

A fear-based decision rarely (in my experience) leads to a positive place, while a confidence-based decision often takes you to a place of pride and awe at your own strength.

You deserve this more than anything else. Fancy a hand figuring it out?

Book a Power Hour with me and we can discuss anything birth and baby related to help you find your confidence-based decisions with ease.