Many of my patients mention they’ve watched “A Birth Story” to prepare for childbirth, which is similar to claiming you’ve watched “The Princess Bride” to understand marriage. Trust me, the reality of giving birth is nothing like a 22-minute show that skips over the gritty details!
A common misconception among expectant mothers is the assumption that they can rely solely on an epidural for pain relief, thinking labor pain is optional. Let’s set the record straight about childbirth pain:
1. Pain is Almost Inevitable
For every woman who gives birth, some level of pain is nearly universal, even with an epidural. Why? Because you typically won’t receive an epidural until you reach active labor, which is when you’re about four centimeters dilated. This is critical because research indicates that waiting until active labor to get an epidural decreases the likelihood of unnecessary C-sections, and trust me, you don’t want to go down that path.
How long does it take to reach that four-centimeter mark? You could endure hours—sometimes even days—of contractions before hitting that magic number. These contractions can feel quite intense. While IV pain medications provide some relief, they usually only help for the first few doses, which last just a few hours. As a result, you might endure significant pain before receiving your epidural.
2. Epidurals Aren’t Always Perfect
An epidural involves a long needle (which you won’t feel thanks to numbing medication) inserted into your spinal column to deliver pain relief. Ideally, it should numb both your abdomen and legs evenly. However, in about 5-8% of cases, the pain relief isn’t symmetrical. The catheter can sometimes shift to one side, leaving one side numb while the other still feels contractions. Your nurse will attempt to adjust your position to fix this, but it doesn’t always work. There may also be “windows” on your body that remain sensitive to pain despite the epidural. Unfortunately, this is the reality of the situation.
3. Epidurals May Not Provide Relief When Pushing
One of the most surprising letdowns for many women is that when it’s time to push, the epidural may seem ineffective. This can happen because the nerves affected by the descending fetal head may not receive adequate relief. Adding more medication might leave you unable to push, but it won’t alleviate the pain. The only option is to push the baby out.
Managing Pain During Labor
Understanding what to expect regarding labor pain can motivate you to prepare effectively, which is why I encourage participating in birthing classes. Today’s classes are far from the outdated methods—gone are the days of simple breathing exercises. Instructors now teach more advanced relaxation techniques that help you regain control during this overwhelming experience. You’ll also learn about the physiology of childbirth, giving you insight into what’s happening in your body. A good instructor can also prepare you for potential medical procedures during your hospital stay and what to expect in the initial days at home.
I often advise patients to visualize labor as swimming in a choppy ocean. Just like the ocean, labor is a powerful force that can toss you around. Your instinct is to escape from pain, but with labor, the more you tense up, the more intense the pain can become. The key is to relax and ride the wave rather than fight against it.
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Summary
Childbirth pain is a common experience for nearly all women, even with the use of an epidural. Understanding this reality can help expectant mothers prepare for the emotional and physical challenges ahead. Engaging in birthing classes can provide valuable techniques for managing pain and navigating labor, making the experience less daunting.