Labor = Pain.
Most people would agree with that statement. There are some who have had the Labor = Ecstatic version, but seeing that is far and few between I’ll keep to the first notion.
Now, I am sure that most women realize that they will experience pain when they go into labor. I’ve discussed that some seem to be quite surprised that they have to experience pain, but I won’t go into that again. So, assuming that every woman who is due to give birth at some point in their life will have a first hand account with labor pain, I figured that it might be helpful to understand a few things about that pain.
What does labor pain come from? Well, duh, Labor Nurse, it comes from the contracting uterus and a large baby exiting your nether regions. Yup, you are right. But, it is more than that.
- Dilation and effacement of the cervix. The opening and thinning of the cervix while a baby’s head is rammed up against it can be unpleasant.
- Pressure of the baby within the pelvis. Imagine placing an 8 pound bowling ball in your rectum and holding it there while it is intermittently squeezed resulting in an increase in that sensation.
- Pressure from the contracting uterus against surrounding organs. The uterus isn’t floating in its own orbit; it is smooshed against your other organs (like your bladder and intestines) and causes them to hurt, too.
- The increase of lactic acid within the uterine muscle. Actually, the uterus is just one big muscle, and when it is exercised, so to speak, for hours and hours it will make lactic acid. It’s pretty much the same thing as an over worked bicep or quadriceps muscle if you exercise it too much.
- And of course, the most obvious: stretching of the perineal and vaginal tissue with a descending baby. This pain has frequently been referred to as the infamous Ring Of Fire.
Another factor contributing to labor pain is your personal and cultural beliefs and experiences surrounding pain. Think back to a time in your life when you had some serious pain. How did you react to that? Did you find anything that helped you cope with it? How did that change your view of any future anticipated pain? I’ve personally found that women who have had bad experiences with pain in their past that they were unable to cope with for whatever reason have a really hard time when labor kicked in. On the other hand, women who approached previous pain with a mindset that they can deal with it one way or another have an easier time getting through contractions. I’m not saying that if you merely winced when your arm got chopped off that you can whistle through contractions; what I mean is that those who have been able to successfully tackle and mentally cope with whatever pain they’ve experienced seem to be able to accept and get through labor without losing their minds. And when I say “tackle and mentally cope”, this means that the person found something to help them. What that something was can vary considerably, and it actually doesn’t really matter. It was that they found something that was important.
Women who have a hard time coping through labor can actually make their pain worse by merely being afraid of it. Pain is heightened by fear and tension. And this turns into a self feeding cycle. You have pain, you tense up, you become afraid of what your feeling, which further increases tension, which increases the level of pain experienced…. you get the idea.
There are a few other things I think are important to address regarding pain. Since most give birth in a hospital, there are some annoying things that have to be done. First is that nurses must document pain levels. This is a standard in any area of nursing set forth by our hospital’s lovely accrediting body (JCAHO). So we have to ask what your pain level is on a scale of 1-10. If we are solely looking at how this works for documentation purposes, providing a number helps anyone looking at the chart see the progression and/or relief of pain. But it’s very annoying to ask a woman who is clearly experiencing a lot of pain, “What number would you give this pain?” Like she cares to answer. I think I’d probably answer something like, “Who the fuck cares? It hurts!” but unfortunately we need that damn number.
The other thing is that many people get caught up in what the monitor is telling us. I can’t tell you how frustrating it is to see family members staring at the monitor during a contraction and hear them say, “But honey, that one only registered a 35 on the monitor!” when she is moaning and writhing in pain. Unless the woman has an internal uterine contraction monitoring device, that monitor isn’t telling anyone shit about the pain level. Only the woman can tell us that. So stop looking at the monitor (I wish we didn’t have to use them… it would solve so many problems).
Lastly, think about the traditional definition of pain. Pain is typically defined as suffering caused by injury or illness. Labor does not signify injury or illness. It’s a normal, natural physiological process. But our society seems to forget this and equates this normal pain with pathological pain that must be treated and fixed. And so many times women jump into the whole pain, tension, fear cycle because their mind is telling them that their pain is abnormal and something must be wrong. But there isn't.