Labor Pain Management
Labor pain is unique and quite different from everyday chronic and acute pain. Generally, pain is a warning sign that something is wrong, but labor pain acts as an "alert" that the birth process is underway and that you need a safe environment in which to give birth. Some women prefer a homelike environment, which has been shown to have many benefits, including reducing the need for medical forms of pain relief. For this reason, many labor rooms in maternity units and especially birth centers have homey decoration and furnishings to make them feel less medicalized. Other women need the reassurance provided by hospitals that stronger forms of pain relief and medical backup are available.
No one really knows what starts labor and every woman's labor is unique. Likewise, the pain associated with labor can vary enormously between women. Some women have relatively painless labors, while some describe the pain as moderate, and others experience severe pain. One thing that does seem clear is that anxiety and fear increase the levels of adrenaline, which in turn can increase the intensity of the pain experienced. The strength of labor pain can also be affected by factors such as your emotional state and anticipation of labor; your previous experiences, if any; cultural beliefs; and, in particular for first-time mothers, the fear of the unknown. Thorough preparation prior to labor and sensitive and caring support throughout labor and birth can help reduce anxiety and fear considerably.
The sensation of pain is different during the different stages of labor, and as labor progresses the intensity and duration of the pain increases. The most effective methods of dealing with pain will also change as your labor progresses.
The more familiar you are with the methods of dealing with pain and with the several natural and drug-induced methods of pain relief available (see Natural Pain Relief), the easier it will be for you to manage during labor and birth. To make decisions about pain relief, you will also need to understand the changes that take place in your body during the three different stages of labor .
Your pain-relief requirements may change during labor, so it helps to be aware of when different types of pain relief can help.
Early first stage In this phase, the cervix begins to dilate. Contractions are mild, and you may find that natural methods, such as massage and breathing, are helpful. If you need stronger pain relief, you may be given analgesics, which dull pain but allow you to remain active since you won't lose all feeling or muscle movement.
Active first stage The cervix now starts to dilate more quickly and contractions are stronger and closer together. Some women are happy to continue with natural or analgesic pain relief; others may need stronger relief and an epidural may be given at this point (see Epidurals).
Transition Contractions are intense and frequent as the cervix dilates fully. Systemic (IV) analgesics aren't usually given this close to the birth since they could affect the baby. If you have an epidural already in place, this can be topped off.
Second and third stages Stage two lasts from full dilation of the cervix until birth; contractions are strong and longer lasting, but easier to manage since you start pushing. Analgesics may be used. In the 3rd stage, delivery of the placenta, contractions are mild and you shouldn't need pain relief.
Being informed about the pain of labor can reduce your anxiety and help you manage.