How labor feels

Labor is different for every woman. Common ways women describe it includes:

  • Cramping, like you’re getting period or diarrhea.
  • Lower back pain radiating around to the front and back again.
  • Wavelike in the beginning and becoming more intense as labor progresses.
  • Later on (in Active labor) you may also have nausea, vomiting, chills, painful backache, tremors and a sense of desperation.

What causes pain?

Fear increases tension; tension intensifies pain, and pain produces additional anxiety that leads to fear and further tension. You can break this cycle through knowledge and relaxation techniques, which reduces the perception of and feelings of pain.

Pain threshold is the level at which a person actually perceives pain, and this is different from person to person. Pain tolerance is the ability to tolerate pain, which is also very individualized. We will all feel it differently and at varying degrees. For example, if I were to pinch you really hard and 30 seconds later you say “ouch!” then I have reached your pain threshold. I keep pinching you and another 30 seconds later you say “enough!” then I have reached your pain tolerance. If you have learned a coping technique like controlled breathing, then you can begin to use that when you have said “enough!” and you will be able to handle the pain for longer.

For most women there will be pain in childbirth. But preparation and support will generally increase your tolerance for pain. Labor is a natural process that all women are built to do and can handle. And remember, this is a beautiful pain and with a purpose; after all that hard work you get a beautiful baby! Most women say the pain disappears once your child is in your arms.

How to make labor easier

Your body produces hormones naturally to help labor to be easier and you can increase these hormones by doing the following:

  • Practice relaxation exercises: see below for a step-by-step guide.
  • Get a massage: ask your husband or the midwife to rub your lower back, which many women feel comforting especially during a contraction.
  • Take a shower or bath: you can do this if you stay at home during Early labor.
  • Get support: if you stay at home during Early labor you can have a support partner (husband, mother, mother-in-law, friend) help.
  • Change positions: lying flat on your back is not helpful, walk and change positions often if able.

Most importantly, believe in yourself! You can do it. Your body was made to do this. For centuries women have been giving birth. Don’t be afraid, it is a natural process.

Relaxation exercises

There is a range of different relaxation exercises you can practice to make labor easier.

1. Visualization

Try creating a comforting image in your mind, like the following:

  • Use your imagination in a positive way to imagine a pleasant scene or place you would like to be.
  • Visualize your cervix as a flower opening, imagine your cervix and baby opening and your baby moving downwards during each contraction.
  • Create a focal point, a picture, a person, or an imagined/remembered route e.g. stairs or walking path.

2. Vocalization

Try repeating a comforting phrase aloud (or to yourself), like the following:

  • I can, I can, I can
  • A breath for you, A breath for me
  • I love you, You love me

You can also try counting aloud or to yourself.

3. Breathing techniques

Source: American Pregnancy Association, see http://americanpregnancy.org/labor-and-birth/patterned-breathing/

Slow breathing

Begin slow breathing when contractions are intense enough that you can no longer walk or talk through them without pausing.

  • Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over—head to toe) as you breathe out.
  • Focus your attention
  • Slowly inhale through your nose and exhale through your mouth, allowing all your air to flow out with a sigh. Pause until the air seems to “want” to come in again.
  • With each exhale, focus on relaxing a different part of your body

Light Accelerated Breathing

Most women feel the need to switch to light breathing at some time during the active phase of labor. Let the intensity of your contractions guide you in deciding if and when to use light breathing. Breathe in and out rapidly through your mouth about one breath per second. Keep your breathing shallow and light. Your inhalations should be quiet, but your exhalation clearly audible.

  • Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over—head to toe) as you breathe out.
  • Focus your attention.
  • Inhale slowly through your nose and exhale through your mouth.  Accelerate and lighten your breathing as the contraction increases in intensity. If the contraction peaks early, then you will have to accelerate early in the contraction. It if peaks more gradually, you will work up to peak speed more slowly. Keep your mouth and shoulders relaxed.
  • As your breathing rate increases toward the peak of your contraction, breathe in and out lightly through your mouth. Keep your breathing shallow and light at a rate of about one breath per second.
  • As the contraction decreases in intensity, gradually slow your breathing rate, switching back to breathing in through your nose and out through your mouth.
  • When the contraction ends, take your finishing breath—exhale with a sigh.

Variable (Transition) Breathing

This is a variation of light breathing. It is sometimes referred to as “pant-pant-blow” or “hee-hee-who” breathing. Variable breathing combines light shallow breathing with a periodic longer or more pronounced exhalation. Variable breathing is used in the first stage if you feel overwhelmed, unable to relax, in despair, or exhausted.

  • Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over—head to toe) as you breathe out.
  • Focus your attention on your partner or a focal point, such as a picture.
  • Breathe through your mouth in light shallow breaths at a rate of 5-20 breaths in 10 seconds, throughout the contraction.
  • After every second, third, fourth, or fifth breath, blow out a longer breath. You might try verbalizing this longer exhale with a “who or “puh.”
  • When the contraction ends take one or two deep relaxing breaths with a sigh.

Breathing To Avoid Pushing At The Wrong Time

There will be times throughout both stages of labor when you will want to push or bear down and it is not the right time. Most women want to hold their breath during these particularly difficult moments.

Avoid holding your breath by breathing in and out constantly or by raising your chin and blowing or panting. This keeps you from adding to the pushing that your body is already doing.

Expulsion Breathing

Used once the cervix is fully dilated and the second stage of labor has begun.

  • Take an organizing breath—a big sigh as soon as the contraction begins. Release all tension (go limp all over—head to toe) as you breathe out.
  • Focus on the baby moving down and out, or on another positive image.
  • Breathe slowly, letting the contraction guide you in accelerating or lightening your breathing as necessary for comfort. When you cannot resist the urge to push (when it “demands” that you join in), take a big breath, tuck chin to chest, curl your body and lean forward. Then bear down, while holding your breath or slowly releasing air by grunting, moaning or other verbalizing. Most important of all, relax the pelvic floor. Help the baby come down by releasing any tension in the perineum.
  • After 5-6 seconds, release your breath and breathe in and out.  When the urge to push takes over join in by bearing down. How hard you push is dictated by your sensation. You will continue in this way until the contraction subsides. The urge to push comes and goes in waves during the contraction. Use these breaks to breathe deeply providing oxygen to your blood & sufficient oxygen for the baby.
  • When the contraction ends, relax your body and take one or two calming breaths.

Positions and pushing

Positions for Labor and Pushing

There is no one best position. In fact, most women end up changing positions frequently during labor. Let your body be your guide. It is best not to lie down for too long. Studies have shown that women who tended to walk or stay upright during early and active labor reduced their labor time by one hour.

Sometimes, a medical condition will dictate what's best for you and your baby. If you have any complications that require continuous monitoring and you need to stay tethered to a monitor by a cord, your ability to move around will be limited. Occasionally a baby's heart rate will indicate that he prefers you to be in one position or another.

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Pushing Types

Explain there are two main types of pushing: Coached and Spontaneous. Spontaneous pushing is when you follow your body's natural urges, pushing when and if you feel ready, and in whatever way feels right to you. Many women find this the easiest method. It is important that you do not push before you are fully dilated and the nurses/midwives should tell you to resist pushing in this case. It is important for you to listen to the midwife/nurse and follow their instructions. Coached pushing, where you are directed to begin pushing as soon as you are fully dilated, at the beginning of each contraction, whether or not you feel an urge to bear down. You may also be given instructions for how to push. Most importantly, don’t be afraid. The pushing stage is the “home stretch”; many women find it feels good and is a relief to push.

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Complications

Complications during a vaginal birth are relatively rare, but they can happen. It might be helpful for you to understand some of the medical procedures the doctor might do to help deliver your baby safely:

Induction and augmentation – this might happen due to: 1) Delayed labor (when labor does not start or progress safely on its own); 2) Tests show that your placenta is no longer functioning properly, you have too little amniotic fluid, or your baby isn't thriving as he should. 3) You develop preeclampsia; 4) You have a chronic or acute illness that threatens your health or the health of your baby; 5) You have previously had a stillbirth. You should not be induced before 41 weeks unless there is a legitimate medical reason. The doctor can use medication and other techniques to start or speed up your contractions. Some methods you can do at home to start or speed up your contractions include walking, sexual intercourse with semen, and nipple stimulation.

Assisted delivery approaches – this might happen due to a large baby or if a quick birth is necessary. The techniques include:

  • Episiotomy: an incision made in the perineum, which is the tissue between the vaginal opening and the anus.
  • Forceps extraction: a device that looks like a long pair of spoons or tongs gently grips the baby’s head and turns or pulls baby out
  • Vacuum extraction: a cup-shaped device that applies a gentle suction to the top of the baby's head that prevents baby from moving back up the birth canal between contractions and/or assists mother while she is pushing during contractions.

Emergency C-section – this occurs in situations where the mother and/or baby are at serious immediate risk and the baby cannot be safely birthed vaginally. 

Category: How it Feels & How to Cope

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