Labor Pain

Myths and Truth

With so much childbirth information passed on from friends and family members, it can be hard to figure out what is true, and what is not. If you mistakenly base your birthing decisions on a myth or misunderstanding, you are less likely to make a good decision and less likely to feel satisfied with your childbirth experience. Here are some of the most common myths about the pain of childbirth.

Myth #1: Labor is always excruciating.

Truth: When it was actually studied, only about 20% of women said labor was horrible or excruciating. Another 20% said they had low levels of pain. The rest of the labors were somewhere in the middle. Physical indicators that a woman would feel more pain with labor include a history of miscarriage or abortion and menstrual problems. Emotional indictors include difficulty accepting pregnancy, conflict about becoming a mother, being anxious about labor, unstable emotional feelings and a previous psychological issue requiring counseling. Social indicators include less education, younger age, first time mother and a partner who is negative or indifferent toward pregnancy.1,2

Myth #2: You need a high pain tolerance to get through labor.

Truth: Pain tolerance is variable, and many of the skills taught in childbirth classes successfully help women increase their ability to cope with any pain, including the pain of labor. More important is the fact that a strong indicator a woman will cope well with labor is not a high pain tolerance, but confidence in her ability to cope.3 The fact that interaction with those attending a woman at birth influences her ability to cope also shows it isn't a high pain tolerance that helps women get through labor.4

Myth #3: Medication is the only thing that will help.

Truth: Epidurals generally do the best job of removing pain from labor for most women. However, they usually come with side effects the mother did not expect or want. Though they do not provide as much pain relief as an epidural, there are many non-medical ways to cope with the pain with little or no side effects. For example, immersion in water greatly reduces the amount of pain a woman feels.5 Using a doula not only reduces the amount of pain a woman feels, but also reduces the need for other interventions such as forceps and a cesarean.6

Myth #4: Removing the pain means a better birth experience.

Truth: The women who rate their birth experiences the best are not the women who had the least painful births. In fact, women who used epidural pain relief have less positive feelings about their birth experience than women who use no medical pain relief.7,8 Low levels of pain have not been found to be associated with high levels of enjoyment during labor.9 Feeling in control of the decisions being made is more important to a good birth experience than having less pain.10

Myth #5: The most painful labor is a homebirth.

Truth: Planned homebirths are usually very relaxed events in which the mother copes well with the experience of labor. The comfort measures used may not remove the pain of labor as much as they remove the feelings of helplessness the woman has. The encouragement a homebirth mother receives from her support actually helps her manage the labor with less problems. In contrast, the hospital environment is generally not supportive, does not respect the woman and offers little to help besides drugs. "Drugs and technology in birth, as in life, have proved to be poor substitutes for true, human attention."11

References

1 Melxack K, Taenzer P, Feldman P, Kinch R, (1981). Labor is Still Painful After Prepared Childbirth Training. Canadian medical Association Journal, 125:357-363.
2 Lederman r, Lederman E, Work B, McCann D, (1979). The Relationship of Psychological Factors in Pregnancy to Progress in Labor. Nursing Research, 28; 2:94-97.
3 Lowe, N.K. (1993). Maternal confidence for labor: Development of the Childbirth Self-Efficacy Inventory. Research in Nursing and Health, 16(2) 141-149.
4 Standley K, Nicholson J (1980). Observing the childbirth environment: A research model. Birth and the Family Journal, 7, 15.
5 Cluett ER, Nikodem VC, McCandlish RE, Burns EE, (2002). Immersion in water in pregnancy, labour and birth. Cochrane Database of Systematic Reviews2002 Issue 2.
6 Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, (2003). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2003 Issue 3.
7 Bennett A, Hewson D, Booker E, Holliday S (1985). Antenatal preparation and labor support in relation to birth outcomes. Birth 12,9.
8 Morgan B, Bulpitt CJ, Clifton P, Lewis PJ, (1982). Analgesia and satisfaction in childbirth (The Queen Charlotte 1000-mother survey). Lancet, 1, 808.
9 Norr K, Block C, Charles A, Meyering S, Meyer T (1977). Explaining pain and enjoyment in childbirth. Journal of Health and social Behavior, 18, 260.
10 Doering S, Entwisle D, Quinlan D (1980). Modeling the quality of women's birth experience. Journal of American Psychiatry, 45(5), 825-837.
11 Armstrong P, Feldman S. A Wise Birth. London:Pinter & Martin, 2007.