Birth Planning, Physiologic Labor, Research

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. There were some similarities between women who had more pain. Women were more likely to report more pain if they had a history of pregnancy loss or menstrual problems. Some mental health issues made women more likely to report a painful labor including anxiety specifically related to childbirth or a prior mental health issue that required counseling. Women were less likely to report a painful labor when they were older, had already given birth, and had a supportive partner.1,2

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

Truth: Pain tolerance is not the same as the ability to cope with pain. Pain tolerance is the “how strong” something must be for you to recognize it as pain. I may feel pain if you pinch me lightly while you may not feel pain even with a strong pinch. Coping is a measure of ability to deal with pain when it happens. It turns out that the ability to cope with labor is not related to pain tolerance. Instead, the most important thing that predicts coping is confidence in your ability to cope.3 Many of the skills taught in childbirth classes successfully help women increase their ability to cope with pain, including the pain of labor. Also, having positive interactions with the people who attend your labor increases your ability to cope.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, it is not necessary for something to remove all the pain for it to help in labor. Though they do not provide as much pain relief as an epidural, there are other medication many non-medical ways to cope with the pain. 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 delivery 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. This may sound counter-intuitive, but women who used epidural pain relief have less positive feelings about their birth experience than women who use no medical pain relief.7,8 No matter what methods of pain relief a woman used, low levels of pain have not been found to be associated with high levels of enjoyment during labor.9 So what matters for a good birth experience? 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 home birth.

Truth: Planned home births 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 home birth mother receives from her support actually helps her manage the labor with less problems. In contrast, many women find the hospital environment is generally not supportive, does not respect the woman and offers little to help besides drugs.11

“Drugs and technology in birth, as in life, have proved to be poor substitutes for true, human attention.”Penny Armstrong, A Wise Birth

References

1.
Melzack R, Taenzer P, Feldman P, Kinch R. Labour is still painful after prepared childbirth training. Can Med Assoc J. 1981;125(4):357-363. [PMC]
2.
Lederman R, Lederman E, Work B, McCann D. Relationship of psychological factors in pregnancy to progress in labor. Nurs Res. 1979;28(2):94-97. [PubMed]
3.
Lowe N. Maternal confidence for labor: development of the Childbirth Self-Efficacy Inventory. Res Nurs Health. 1993;16(2):141-149. [PubMed]
4.
Standley K, Nicholson J. Observing the Childbirth Environment: A Research Model. B. 1980;7(1):15-20. doi:10.1111/j.1523-536x.1980.tb01360.x
5.
Cluett E, Burns E. Immersion in water in labour and birth. Cochrane Database Syst Rev. 2009;(2):CD000111. [PMC]
6.
Hodnett E, Gates S, Hofmeyr G, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2012;10:CD003766. [PMC]
7.
Bennett A, Hewson D, Booker E, Holliday S. Antenatal preparation and labor support in relation to birth outcomes. Birth. 1985;12(1):9-16. [PubMed]
8.
Morgan B, Bulpitt C, Clifton P, Lewis P. Analgesia and satisfaction in childbirth (the Queen Charlotte’s 1000 Mother Survey). Lancet. 1982;2(8302):808-810. [PubMed]
9.
Norr K, Block C, Charles A, Meyering S, Meyers E. Explaining pain and enjoyment in childbirth. J Health Soc Behav. 1977;18(3):260-275. [PubMed]
10.
Doering S, Entwisle D, Quinlan D. Modeling the quality of women’s birth experience. J Health Soc Behav. 1980;21(1):12-21. [PubMed]
11.
Zielinski R, Ackerson K, Kane L. Planned home birth: benefits, risks, and opportunities. Int J Womens Health. 2015;7:361-377. [PMC]
Jennifer (Author)