Labour Pain: What Does It Actually Feel Like

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Dr. Sabiha Anjum (Obstetrician and Gynaecologist)
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Labour is both an intriguing and intimidating experience. The thought of finally bringing your child into this world, coupled with the associated pain, sparks off a rainbow of emotions that includes anxiety, fear, and excitement. Most women wonder how bad labor pain is and what contractions feel like. However, labor is an extremely individualistic experience, and each mother undergoes different levels of pain and discomfort.

Labor in Pregnancy

Labor is a process that the mother goes through for delivering the baby and is often associated with pain. You can deliver in two ways, vaginally (naturally through the birth canal) or cesarean (surgical procedure). We will describe the most common experiences shared by mothers during different stages of labor that can help you prepare yourself for the most memorable day of your life.

What do Labor Pains Feel Like?

Till your moment of labor arrives, nobody can accurately predict what your labor will be like since the experience is unique for each mother. But before you dig deep into the concept of labor and imagine what contractions feel like, it is ideal to understand labor stages.

Labor can be bifurcated into three stages with unique phases: The first stage of pre-labor and early labor; the second stage of active labor, transition, pushing; and the final stage, which includes delivery of the placenta.

During The Pre-Labor Stage

The pre-labor stage often starts with Braxton-Hicks (false labor) contractions mistaken for actual labor. In some cases, these can be experienced much early in pregnancy, at around 20 weeks. Mothers carrying more than one child can feel these even earlier. Named after an English doctor John Braxton Hicks, these pre-labor contractions are considered practice before the actual event that helps prepare the baby and mother for the delivery. Such cramping is not regular, is painless, and does not cause the cervix to dilate.

Early-labor contractions can occur due to extreme activity, absence of water(dehydration), or hunger and stress. These are often felt in separate spots instead of the whole uterus. The feelings are like plain baby activities or gas, but again the experience is distinctive.

During Early Labor (First Stage)

This phase is the beginning of the labor process. Thinking what labor feels like at this stage? The pre-labor contractions are not regular, while early labor tightenings, often described as the onset of labor, are regular but not too close and usually don’t subside if you eat, drink water, rest, or give enema. Such contractions are noticeable and stay for a lesser duration, and are not very intense. Early contractions can feel like recurring menstrual cramps in labor.

At this juncture, if you feel the contractions are occurring at almost regular intervals and the cervix begins to dilate and efface, you have officially entered labor. Labor contractions at the early stages are sometimes hard to distinguish from the inefficient Braxton Hicks contractions felt in the previous phase.

The onset of regular and consistent contractions is the time to be excited because it means labor is imminent, and the nine-month journey will culminate into birthing. At the outset, there are breaks of longer duration between contractions, often five or 20 minutes break, and each contraction may last 40 to 60 seconds. These are signs for the to-be parents to prepare for the stages ahead.

During Active Labor

You enter into active labor when contractions become more regular, long, and prominent. This is supposed to be the toughest part of labor, where the cervix starts dilating and opens up to make way for the baby to move down. You will start feeling heavy in your lower abdomen as the baby twists and come downwards, exerting a force on the cervix.

The contractions in active labor appear closer together and are often at a gap of around five minutes but hold up for about a minute. These often cause lower backache that shoots painful sensations down the legs. A cycle of cramps that come and leave with the contraction also begins in this phase.

The uterus actively pushes the baby onto the cervix, causing it to dilate, allowing the baby to slip further down. Some feel this as contractions in their stomach area while it may be experienced at the opening of the cervix. However, the real contractions are felt in the stomach radiating from one point on the uterus to throughout the uterus; additional pain may be felt around the cervix.

During the intervals, you should take a breath, eat and relax as it is overwhelming for the mother. The support of your husband or a family member at this phase can be of great help because you are expected to deal with the intensity of regular contractions.

The phase can stretch between four to eight hours (especially for first-timers), while it can even take longer for many. Only a lucky few have it as a short one-hour experience!

For mothers who have had a natural delivery or those getting oxytocin (Pitocin), the phase is usually shorter. Many women also opt for medication in this phase. However, just like the baby’s size, the use of an epidural may increase the duration of the phase.

Transition Phase

Most women fear this part as it comes right before the pushing in labor and can be a period of rapid opening. This is the phase where your cervix dilates to around 10 centimeters. This is the transition between initial labor and the final pushing when the baby starts to arrive, and for some women, this can be painful and overwhelming. However, this transition phase typically lasts between 15 to 30 minutes, going up to a few hours in some cases.

The spaced-out contractions of earlier phases now increase in intensity and are so close together that they seem to be overlapping or even peaking simultaneously. Shivers and vomiting can supplement this stage as your baby starts slipping into a position ideal for birth.

Even as the doctor asks you to be focused emotionally, you may feel like giving up during this phase. Try and remind yourself that this stage is the most crucial and try opening up to the pressure so that your baby descends as the cervix dilates fully. The transition phase is short-lived and rewarding because, towards the end, you can hold your baby in your arms.

During Pushing (Second Stage of Labour)

Now you enter the stage where you will be asked to push once the cervix gets completely dilated with all your strength. This is the ultimate descent when the baby comes out. At this stage, you may feel the contractions are at a gap, giving you time to take a rest between each contraction.

In fact, some women find it easy to tighten in this phase than in active labor because pushing down is relieving. For some, it could be a painless experience, while some are exhausted by pushing. Most mothers describe the pushing phase as similar to the need to poop because the baby exerts pressure on similar organs and causing the same reactions at the time of defecation. This urge instinctively directs the body to continue pushing the baby out effectively.

There is an urge to push early during the second stage or before that if the baby happens to be lower in the pelvis. But if the baby remains on top, you won’t get the feeling to push immediately.

If you manage to pull through the transition labor without drugs, then you will be more alert and participate in this active part of labor. If you manage to keep upright positions, it will make the process easier and physically less taxing.

As the phase progresses, you will encounter the process of crowning when the baby’s head comes out. By now, the urge to push becomes so strong that you will be guided to blow or pant during contractions to help counter it. You may experience a sensation known as a ring of fire at the time of crowning as the vagina tissues tightly stretch over the baby’s head. This brief but painful sensation is helpful because mothers tend to stop pushing and letting the tissues stretch over the baby’s head gently. A slow and controlled delivery can help to prevent tearing of your perineum. The entire second stage can take from a few minutes to several hours. This is also the time episiotomy is given by the doctor if required.

After Birth (Third-stage Labour)

The last stage is basically when you deliver the placenta. Some mothers hardly observe this part. At this stage, breastfeeding can ensure contraction of the uterus post-delivery and cause after-pains or slight contractions. Once detached, the placenta rests in the uterus and makes you feel heavy but delivering it gives you relief as the process is almost painless since it comes off easily. On average, the third stage of labor should not take more than five to 10 minutes.

Conclusion: Now that you have an idea about what labor pain feels like, you also need to remind yourself that nature created these painful cues to remind the body how to react in each phase. Labor is an immensely personal act of bringing your little child into this world – an unforgettable experience. The only thing common to all mothers during successful labor – the bliss in the end!

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