11 Ways to Reduce Labour Pain

Let’s start by demystifying labour and what it might feel like at every stage. Spoiler alert: it’s not what you’d expect!

Intensity and tightening. Labour usually starts with irregular contractions and tightening of your bump. Your contractions are likely to be sporadic, and they will probably feel like period cramps. You could also experience mild lower back pain or discomfort in your pelvis, but you’ll likely be able to talk through your contractions at this stage. In fact, when labour starts, lots of women don’t feel pain at all – they just feel excited and full of anticipation to meet their baby!

Contractions build. As your contractions gradually intensify, it’s likely you won’t be able to talk through them anymore. This is one of the signs that midwives use to recognise that your labour is progressing. If you phone the hospital to say you think you’re in labour and you can’t finish a sentence, then you may be asked to head in as soon as possible (if you plan on giving birth in hospital, that is). What you’re feeling at this stage is the muscles of your uterus lifting up and dilating your cervix. This might be uncomfortable, but any pain you experience during labour can be neutralised by your natural pain-killing hormones – endorphins, which are 10 times stronger than morphine. Your brain will produce these hormones when you feel safe in your birth environment, comfortable with your care providers, and generally supported throughout labour. Many women opt for extra pain relief as labour starts to progress, such as using gas and air, and this can help you to ride each contraction. Some women don’t like gas & air and prefer to go without.

The need to bear down or ‘push’. As your baby starts to move down the birth canal, you are likely to feel a pressure in your lower back. Now is the time you’re most likely to poo because your baby’s head is pushing against your gastrointestinal tract. This quite literally pushes poo out, whether you like it or not. Are you self-conscious about pooing? If so – don’t be; believe it or not, poo is an exciting milestone in the birth process because it means your baby is about to be born. The urge to push during this stage is likely to be uncontrollable, so trust your body and embrace the process.

The ‘ring of fire’. ‘Ring of fire’ is an awful term, but it does describe what it feels like when your baby’s head is crowning. As your baby’s head is born, you may feel a burn or a sting, which is caused by your perineal muscles stretching. This period of labour should be short lived – usually only lasting a matter of moments. Lots of women feel the need to close their legs when this happens, which is completely instinctive. Closing your legs or bringing your knees together actually helps to open up the bottom part of your pelvis – making more room for your baby to be born. During this stage however, many women are asked to lie on their backs with their legs open so that healthcare professionals can see what’s going on. This actually makes less space so isn’t the best position for mother or baby. You don’t need to be on your back if that doesn’t feel right for you – you have every right to decline. Focus on being in whichever position feels good for you and tell those supporting you if you don’t want to lay down, it is their job to take your lead and provide appropriate care in a way that is most comfortable to you

Something that surprises many of my clients is the fact that much of the pain women experience during labour is unnecessary and can be avoided when you’re equipped with the right knowledge. Here are 11 ways that labour can become unnecessarily painful and some strategies for overcoming them:

1. Set up the perfect birth environment

Birth environment matters so much. An environment that makes you feel safe and calm is the best way to help you to connect to the primal part of your brain that is responsible for birth. A brightly lit, noisy and busy birth environment is the greatest threat to your sense of calm, and is the ultimate way that pain is allowed to creep in. Oxytocin and endorphins – which are vital for labour – need darkness, privacy and peace to do their job. If you have the lights on, or are surrounded by people and feel exposed or observed, then adrenaline will get the chance to creep in and will make you go from being calm and relaxed to being in fight or flight which as I’ve explained already – is likely to increase pain. Adrenaline also cuts through our precious pain-killing hormones which increases pain and is likely to mean you’re advised to have medical interventions. This doesn’t have to be bad news if you want some of the proposed interventions however if you want an unmedicalized birth then best to keep adrenaline at bay.

Remember, the best way to bring about oxytocin and endorphins is to be in a dark, calm space and to feel totally secure and comfortable – this will help you to connect to your inner primate and this is when your body will kick into action and give birth to your baby

2. Block out negative language

You don’t need to hear comments like ‘failure to progress’…I mean, what a terrible statement to make. Sadly, it’s a common one in modern day birth settings (hospitals) so there’s a high chance you’ll hear it. Negative language is totally reductive and doesn’t achieve anything; it only serves to discourage you and distract your focus. I would advise blocking out the noise by wearing headphones so you’re in your own bubble, and listen to hypnosis tracks or just your favourite music to stay concentrated and in control. This will boost oxytocin and endorphins which is likely to give your labour a little boost.

3. Refuse unnecessary intervention

Some intervention is necessary, but some is not. Ironically, intervention can actually make birth more painful. A classic example of this is induction, which is typically more painful than a labour that has started spontaneously. Think of birth like going for a long run. If you start spontaneously then your muscles have the chance to warm up, you hydrate, your breathing picks up in line with your increased heart rate and you’re more likely to run further. If however you went from standing still to sprinting with no warm up, well, you’re more likely to get cramp, your muscles will be cold and not as limber, your breathing and your heartrate have to play catch up very quickly. The whole process is going to be much harder.

If you are induced (like many women are every single day) then being aware of the difference between spontaneous labour and an induced labour can help. Remember to breathe through each contraction and let your body warm up in it’s own time. Keep moving as you need to, stay in a position that’s comfortable and stay hydrated. It is always your choice as to whether you accept induction or not. If you ever want to discuss your options please do contact our free pregnancy helpline.

4. Avoid lying on your back

Long gone are the days of women birthing on their backs. I mean, it still happens – but it’s widely renowned to be an unhelpful position. Why? Because your sacrum, which is the triangular bone at the base of your spine, moves out of the way as your baby descends the birth canal. And when you’re horizontal, your sacrum has nowhere to go, which is incredibly painful. The other aspect I want to highlight is that laying on your back actually closes off the bottom of your pelvis which makes less room for your baby to be born. When in the final stages of labour think upright, forward, open and if possible – knees together.

Moving around and regularly switching positions if you need to is one of the most important things you can do to manage pain during labour. Remember, gravity is on your side!. If a midwife asks you to lay on your back – you have the right to refuse. It’s absolutely possible to assess labour without laying down. For example, if necessary you can lay on your side keeping your knees together. This enables midwives to assess and also means your pelvis can move and open as it needs to.

5. Prepare, prepare, prepare!

So you can stay in a deeply relaxed state throughout labour, be sure to gather together your favourite comforts. My top tips are:

• Prepare an epic birth playlist that you can play through headphones to keep you centred.
• Practice massage techniques with your partner in advance so your birth partner knows the best way to sustain your comfort and boost your oxytocin levels.
• Memorise the BRAIN acronym with your birth partner, so that they can advocate for you when your healthcare professionals present you with decisions during labour. B stands for benefits: what are the benefits of making this choice? R stands for risks: are there any risks involved? A stands for alternatives: what are the alternative options? I stands for intuition: what is your gut telling you to do? N stands for nothing: what if we do nothing, and wait it out?
• Complete the Butterbean hypnobirthing course with your birth partner so you feel prepared and ready to work as a team when you go into labour.
  You may have more ideas about how you can prepare, so jot them all down so when the time comes, you can make them happen!

6. Tackle your fears

We’ve already discussed the ‘fear-tension pain cycle’. You feel fear, this in turn creates tension, and this in turn causes pain. Why? Because you stop breathing deeply, meaning your body receives less oxygen. You enter ‘fight or flight’ mode, and your endorphins – which as we’ve learned are 10 times more powerful than morphine – are interrupted by adrenaline. They don’t have a chance to work their pain-relieving magic..

7. Listen to your hypnosis tracks

The butterbean hypnosis tracks are designed to keep you in a deeply relaxed state ahead of birth so that your hormones can do their thing in making labour less painful and more manageable. Listen to the tracks on the Butterbean website as much as possible ahead of labour so that your subconscious is primed to know that birth is not dangerous, and that you’re completely safe.

8. Prepare with yoga

You may not want to take a yoga class during labour, but practising yoga ahead of birth can really help you to familiarise yourself with relaxation and breathing techniques. Knowing how to breathe in labour is so important, and thankfully it’s very simple deep yogic breathing that we do during labour. Taking regular classes also helps to prepare your body for birth, so that when the time comes, you are fitter and know how to make your breath work in your favour.

9. Learn about different positions for birth

You may be encouraged to lay on your back during labour and, as previously mentioned, this may not work for you. Learn about different positions for birth so that you can recognise the ones that you feel will suit you best. That way, you can get into them quickly during labour without having to think too much about it.

10. Get in the pool!

A birth pool is a very effective way to manage pain. The warmth is soothing to your muscles, being in water makes you more buoyant which can be really soothing. It also creates a sense of privacy, and is a brilliant way to boost oxytocin and endorphins. If you don’t have a birth pool you can get in the bath or even try running a hot shower over your lower back.

11. Seek out a TENS machine

A TENS machine is a sure-fire way of boosting your endorphins. The sticky pads are placed on your back, and they release electrical pulses which trigger your brain to produce more endorphins. This has a powerful pain-relieving effect, but a word of warning to birth partners – a TENS machine can be turned up very high during labour, so avoid touching the sticky pads. You might get a bit of a shock!

The biggest factor in painful contractions is a compromised birth environment. If you feel at all scared, observed, or at risk, your body goes into ‘fight or flight’ mode and adrenaline creeps in. Blood is sent away from your uterus, and the release of endorphins and oxytocin is stalled. This is what makes labour painful. Like any muscle, your uterus relies on a supply of oxygen to function, so when blood flow becomes insufficient, it ceases to operate properly. It’s essentially like having a really bad cramp – so we want to avoid this.

Laying on your back can also contribute to painful contractions. This is because your pelvis will be trying to open by as much as 28% during birth, and laying down makes this process much harder.

Let’s face it, labour is an all-consuming physical and mental experience. It’s going to be intense, but it’s nothing to be afraid of if you take control and listen to your instincts. It’s perfectly normal for women to roar their way into motherhood because the feelings they experience are just so fierce. Or, on the flip side they may do it silently. There is no right or wrong way to be during labour. Remember that contractions go in waves, and between them you shouldn’t feel a thing. When you’re approaching the peak of a contraction – this is when you’re likely to experience pain, but it should only last for a few seconds.

This will depend on each individual person, but most contractions don’t last for more than 1 minute at a time, and that is at the peak of labour when things are most intense. At the beginning of labour they will be sporadic and will likely be very mild.

Each contraction will vary in length and intensity, but as labour picks up, so will contractions. They take a while to find their flow but eventually establish a rhythm. Think of labour like a marathon – every contraction is a mile under your belt and once you get to the finish line you can look back on how far you have come.

It’s important to remember that childbirth is not painful the whole way through. The pain comes and goes like waves in the ocean. Each time you feel a contraction, it’s like a wave building up. At first, it’s not too intense, like a small wave starting at 1 on the spectrum of pain. It lasts for about 60 seconds or so, and as it endures it gets stronger until it reaches a peak of say 10 on the scale. Then, like a wave crashing and fading away, the pain lessens and eventually dies off. As labour progresses, contractions may come more often, but that doesn’t mean they hurt more. They still follow the same pattern of starting small, building up, and then easing off. So, even though labour can be intense, it’s absolutely manageable, like riding waves until you reach the shore.