Pain during childbirth

At the start of the delivery, the pain is dull. Many say that it can be likened to severe menstrual cramps. You may experience lower-back pain, it can radiate down to the legs or the lower part of your stomach.

Later in the delivery, the pain becomes more intense. The pain is located in the stomach, back and down into the legs. It is common to feel a heavy pressure in the pelvis, as the child is pushing downwards.

The contractions have a pain peak

The pain comes in limited contractions. A contraction often starts softly. It then builds for a few seconds, when it hurts more. Towards the end of the contraction, the pain is the worst, and then the pain subsides quickly. A contraction usually lasts between 30 seconds and 2 minutes. Most of the time, the contractions are weaker and further apart at the beginning of the delivery. Usually, they are not extremely painful right away.

Pain-free pauses

When the contraction has subsided, there is a pause. You are usually completely free of pain at that point, and have some time to recover. The pauses in-between contractions usually lasts from around one minute to as much as ten minutes. The length of the pauses varies. It depends how far along you are in the labour.

You may feel a burning sensation when the baby comes

As the baby pushes through the vagina, you may experience a strong burning sensation in the pelvic area. You may get some relief if the midwife holds a warm towel against the perineum. The perineum is the area between the vagina and the anus.

How much does it hurt?

The pain you feel when you give birth is one of the most intense forms of pain that you can experience. However, how much you think it hurts varies a great deal between individuals. Some people who have had kidney stones think it hurts about the same.

How well you manage the pain can depend on different things, such as:

• How prepared you are. How you have been feeling beforehand and how well you have slept.
• Your previous experience.
• How long the delivery lasts.
• The size of the baby.
• The size of your pelvis.

If you are worried about pain or anxious about the delivery, it is good to talk to a midwife at the maternity clinic. If you are feeling very anxious, they can help you with the fear of childbirth.

Maternity clinics usually offer parenting classes as well. There, you can learn more about childbirth and how you can prepare.

You can learn and practice breathing techniques, massaging and relaxation. Try to trust in yourself and your body.

Another way to prepare is to trust the staff. It is difficult to know in advance what the delivery will be like and how it will feel. The staff is equipped with experience and knowledge so that they can help you manage the pain no matter what the delivery is like. It can help to write a birth plan if it feels important to communicate your thoughts to the staff.

In order for the baby to come out of the uterus, the cervix is shortened and starts to open. The uterus starts to contract. Once the cervix is fully open, the baby can start to come down through the birth canal. It is then time to push the baby out through the vagina, which dilates to make this possible.

Once the baby is born, the placenta must be pushed out. The placenta is soft and much smaller than the baby is. It usually comes out with a push or two.

The pain is not dangerous

The heavy contractions and the baby passing through the birth canal cause the pain that you feel when you give birth. The pain is not dangerous but your body might interpret it as a threat. Then you may feel scared and anxious.

You can prepare yourself to manage the pain. You can for example use different breathing techniques or move your body.

Afterpains

Once the baby and placenta are out, the uterus starts to contract to shrink down again. This is called afterpains. These are not as intense as the ones during childbirth, but feel like less painful contractions. The contractions are usually irregular. Normally, you will have afterpains for a day or two.

Pain from tears and wounds

After the birth, your pelvic area will feel swollen and tender, especially if you have had tears.

You may feel nervous to go to the toilet afterwards. Most of the time, there is no problem. You should not feel any pain. The midwife can empty your bladder with a catheter if you have difficulty urinating. You may need to take a laxative to make it easier to have a bowel movement if you have had larger tears.

If you are in a lot of pain, it is good to ask a doctor or midwife to examine you to see if you need any treatment.

The body is made to handle pain. During childbirth, your body produces large amounts of a pain-relief substance called endorphins. The endorphins help you to manage much more pain than usual. Endorphins are also formed during massages, touching, acupuncture and TENS.These pain-relief methods reinforce the body’s own pain management system.

Pain is often associated with danger or illness. For that reason, pain can be scary. It can also give you anxiety. It can help to remember that the pain of giving birth is not dangerous, but rather exactly as it should be.

It can hurt more if you are afraid. If that is the case, it can help to work through the fear. Prepare yourself mentally for what to do when the pain intensifies. Practice your calm breathing. Try to put words on what you feel. Create an image in your head of what the pain will lead to.

It can also help to remember that the pain will pass. It is temporary.

When your body is in pain, it sends signals to the brain. The pain signals go through the nerves. The brain receives information about how much it hurts and where the pain is located. Some of the nerve signals pass through an area of the brain that deals with emotions. These nerves are particularly stimulated if you experience fear and anxiety. It calms the nerves if you feel safe and relaxed.

By practising relaxation techniques before the delivery and using them during the childbirth, you can reduce your fear and thereby the pain.

There are different ways of managing pain. You can:

• Ignore it. Continue what you are doing, not allowing the pain to control you.
• Distract yourself. Take a bath, watch a film, listen to music or do something else you enjoy.
• Accept it. Remember that pain is part of the childbirth. This pain is bringing you closer to meeting your child.

There are different methods to numb and reduce the pain. Drugs are used for some of them. These are called medical methods.

Other methods trigger the body’s own pain-relief system. These are called non-medical or natural methods.

Examples of non-medical pain relief:

• heat as pain relief
• massage as pain relief
• TENS
• acupuncture
• sterile water injections
• warm cloths held against the perineum during the second stage of labour.

Examples of medical pain relief:

• nitrous oxide
• spinal block
• paracervical block (PCB)
• pudendal nerve block (PDB)
• local anaesthetic

The best pain relief method varies from person to person and from birth to birth.

It can also be difficult to know in advance what method you would like to try. You can consult with your midwife and decide as the labour is progressing. You can also change your mind during the birth and try different methods.

All medical pain relief is offered by the health service. However, you decide for yourself if you want pain relief or not.

It is common to try different forms of pain relief during a birth. At first, when the pain is dull, it can be enough to use heat, relaxation or massage. You can take painkillers with paracetamol. You can also get a morphine injection if you are in a lot of pain.

Later in the delivery, as the pain intensifies, it is common to use drugs such as nitrous oxide or a spinal block.

Some want a lot of medical pain relief throughout the birth. Others want to avoid drugs and use methods such as massage and heat throughout the birth. It can be difficult to know beforehand what kind of pain relief suits you best. It can be good to think about what you want, but not to feel disappointed if things turn out differently. 

Different maternity wards sometimes have different traditions. Some use certain methods more often than others do. However, you can always trust that you will have help with pain relief based on your needs.

Every delivery is unique. It is impossible to say what the pain will be like based on what it felt like the last time you gave birth. It is common for the labour to be shorter if you have given birth before.

You may need extra support and perhaps medical pain relief already at the start of the delivery if you experienced severe pain during a previous birth. Plan for this together with a midwife or doctor.

It can be hard for the person who is not giving birth to see someone they love in a lot of pain. It can be good to think about how you might react to this beforehand.

During the birth, you can help and assist. You have an important role to play. It can feel like a great responsibility, and it is good to come prepared. Perhaps attend a preparatory class. You can also study up on childbirth, talk about it and write a birth plan together with the person giving birth.

You may both feel more assured if you know in advance what the person giving birth wants. Perhaps you can massage, warm up heating pads and assist in other ways. Plan and practice together already during the pregnancy to decide how you can help.

During labour, it may be difficult for the person giving birth to express their needs. If that happens, it can be good if you know beforehand what they think and want. Then you can help by telling the staff what the person giving birth wants.

When you give birth through caesarean section, you are under anaesthesia so you will not feel any pain.

Normally, you will be given a spinal block before the caesarean section. During the actual surgery, you may feel the doctor pulling on your stomach, which can be uncomfortable. However, it should not hurt.

After the caesarean section, you may feel pain from the surgical wound. This pain is located in the lower abdomen. If you move a lot, it may hurt more. It can be especially difficult to go from lying down to sitting or standing.

You may need to take painkillers for two to three weeks. 

In accordance with the Patient Act, you have the possibility as a patient to influence your own care.

In order to participate in your own care and treatment, it is important that you understand the information given to you by health service staff. Ask questions if you do not understand. You have the right to information about treatment options for example.

If you do not speak Swedish, you can request an interpreter. You can request an interpreter if you have a hearing impairment. If you need any aids, you have the right to information about what is available and how to receive these.