Some time ago, I came across a wonderful piece of wisdom: "You never lose your strength - sometimes you just forget that you have it." As a midwife, this immediately made me think of the many women who have given birth with me. They have all experienced the pain of labour and were able to trust that they could cope with it using their own strength. We midwives support the women during labour in every way we can to keep in touch with their strength. That's why the aforementioned wisdom sums it up perfectly for me: trust your strength!
As a midwife, I am often asked by pregnant women about the upcoming birth and the associated pain - especially as the due date approaches. Even in my Online midwife counselling and my Online courses for birth preparation I regularly hear questions about labour pain. That's why I would like to take up the topic here - and encourage you!
But first I'll tell you openly and honestly: yes, labour is painful. First-time mothers in particular often have great respect for what awaits them in the delivery room. And even some second or third-time mothers sometimes remember a previous labour as very painful and are therefore uncertain or even worried about the next birth. To make matters worse, in my experience, some mothers among their friends or family tend to describe the birth they experienced to pregnant women in very strong colours. The internet is also teeming with such "vivid" birth stories that are "shared" there. However, such stories can quickly (additionally) unsettle expectant mothers. Under no circumstances should you allow yourself to be impressed by such reports. Because no two births are the same. And every woman experiences her birth differently. It is therefore impossible for you to base your judgement on such experiences.
What are labour pains?
Everyone has experienced pain in one way or another. Injuries, bruises, an inflamed tooth, tension - it all hurts a lot. This "normal" pain signals to us that something is wrong with our body. They are therefore an alarm signal.
Labour pain is completely different: it is none Alarm sign! On the contrary, everything is in perfect order with your body if you feel contractions shortly before and during labour. This natural, healthy - and important! - physical reaction indicates a process of change: It signals that your child wants to be born now. A new person is entering your life, which will change forever.
"Contractions" are caused by the uterine muscles rhythmically contracting and relaxing again. The woman has no influence on this, it simply happens "all by itself". A distinction is made between different types of labour in terms of their function and effect:
- Exercise contractions prepare your body for the birth.
- Lowering labour allow your baby to slide deeper into your pelvis before birth.
- Labour pains help your baby to pass through the birth canal and be born safely. And they help you and your body to support this process and stay comfortable. Labour pains are the most painful type of contractions and are divided into opening contractions and exit contractions.
- Postpartum labour detach the placenta and expel it.
For the sake of completeness, I would also like to mention the Aftermath or so-called Stillwehen mention. They occur one to three days after the birth and promote the involution of your uterus.
If you would like to read more about the different types of labour, their tasks and effects, you can find out more on my blog here. I also explain the different types of labour in detail in my Online birth preparation course.
Fears produce tension
A good level of information helps women to look forward to the birth with confidence. However, some pregnant women torment themselves with countless questions beforehand: Will I really be able to withstand the pain? Will this birth be just as hard as the last one? Will my child be healthy? And how will I cope with life with him? Will there be enough money? Will I be able to be a good mum? These are all questions that go round and round in your head and can cause inner fear.
However, as in many situations, fear is also a bad companion during labour - if only because it causes tension in the woman giving birth from the outset. Tension can in turn slow down the labour process. This is easy to imagine: the more tense a labouring woman is, the more difficult it is for her baby to make its way into the world. The uterus will then work twice as hard and react to the situation with increased contractions. This causes further pain, which in turn increases the tension... This creates a spiral of fear and tension.
How you can prevent tension
You can do something before the birth to prevent this spiral: If you have worries and fears - talk about them with people you trust! This will relieve and relax you. Your caring midwife is always a reliable contact person you can turn to. And of course I am also available to you in my Online midwife counselling available for this. It is also part of our job as midwives to help "our" pregnant women to reduce their worries and fears. You can also contact a counselling centre for this purpose. There, it may even be possible to identify deeper-seated fears and deal with them in such a way that they do not have a negative impact on the birth process.
I also advise every pregnant woman to take a antenatal class. Here you will also learn relaxation techniques that will help you to cope with the contractions. In my experience as an obstetrician, if more anxious mothers manage to deal with labour as relaxed as possible, they often experience the actual pain as much less severe than they imagined.
Expectations of pain
"The birth wasn't as bad as I thought it would be." This sentence from the mouths of new mothers is not uncommon. It says something about the expectations women had during pregnancy about the pain of labour and its intensity. Such expectations also play a role before and during labour. I have seen women giving birth who waited throughout the entire labour for the most intense pain they had imagined - but never experienced it until their baby's first cry. This leads to the conclusion that the expectation of (severe) labour pain does not necessarily cause it in everyone. However, there is also the opposite case: a pregnant woman is firmly convinced that she can easily cope with the labour pains - and is then taken completely by surprise by their intensity.
The subjective perception of pain also plays a role here. Some people have a high pain tolerance and perceive something as "still bearable". Others, on the other hand, quickly feel overwhelmed by the pain and brought to the edge of tolerability. In this way, every single woman brings her own personal experience of pain to the birth. And that is absolutely okay. Any categorisation as "more" or "less" brave, for example, would be completely out of place. Every woman giving birth has the right to her own feelings, the right to be as she is - and the right to the right individual support!
This is where we midwives in the delivery room come into play: it is our job to support every labouring mother and give her the confidence to become an expert in her own right. However, we midwives can only achieve this if the mums-to-be come to the delivery room well prepared. If they have already been able to master the latency phase with confidence and self-determination. To ensure that you succeed in this, you should Birth preparation course preferably together with your partner, who you are taking with you to the birth. Ideally, you can then decide for yourself what would be good for you - e.g. movement, a massage from your labour companion, encouragement or simply "Leave me alone if possible!". You can also decide in which position you want to bring your child into the world. If you succeed in doing this, you will become an active labourer and a manager of your pain.
Then you will see: Giving birth is work - but it doesn't hurt that much.
A protective environment in which you can feel comfortable supports the birth process. This is why the choice of birthplace is important. It is not (only) the distance that is an argument in favour of the place of birth, but whether you can feel protected and in good hands there.
Pain relief
Firstly, you should definitely know this: No woman is helpless in the face of labour pains. Your own body is a very important helper. It has hormonal mechanisms for self-regulation and very reliably releases the body's own painkillers (e.g. endorphins) during labour.
It is also reassuring for many women giving birth to know that they can rely on external pain relief: If I wish, I can also resort to external pain-relieving agents and methods. This reassurance takes away most of the fear of labour pain for many women.
Alternative pain therapies include, for example, massages, exercise, breathing and relaxation exercises, changing position, a warm bath, acupuncture, acupressure, aromatherapy or the administration of homeopathic remedies. Many women cope well with these gentle methods of pain relief in the labour room.
Conventional medical treatments for pain relief in clinics include antispasmodics, pain-relieving medication and the now widely used epidural anaesthesia (PDA).
I always recommend to "my" pregnant women that they already before birth about the advantages and disadvantages of the various pain-relieving methods and remedies. Then they will know the options and will be better able to decide in favour of or against a measure in the delivery room.
What is not very helpful, however, is that if you have already given birth unalterable decide what you absolutely want or definitely want to reject. My advice: Inform yourself well beforehand - but still keep an open mind about the birth process and what is to come. If you have a Birth plan this will be very helpful for you. However, it's also okay to throw out the signposts you've laid out if the birth turns out differently than expected.
At this point, I would also like to make it clear: No woman giving birth has "failed" because she gave birth with an epidural or needed painkillers. That doesn't make this birth "less worthy"! Time and time again I meet mothers who want to give birth to their baby "naturally" without any medication or obstetric interventions and who have prepared themselves very well for this. And then afterwards they are disappointed or even feel guilty when they have been given pain-relieving medication, an epidural or even a caesarean section that has become necessary.
Never forget: your body performs the same great service in any case - with or without painkillers. And ultimately, the birth process does not depend on you alone. It also depends on how your child is doing and how the obstetric team assesses the situation.
If you have a feeling of failure after the birth, I recommend that you discuss this with your midwife. Don't be afraid to seek therapeutic support if the feeling continues to torment you. After all, no stressful birth experience should stand in the way of your (new) role as a mother and a successful relationship with your child.
Some women also fear that their bond with the child will be impaired or impaired if they give birth with painkillers. I can reassure you here too: This is not the case!
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