Sample Childbirth Class Session #2

Working with Pain in Labor and Birth

              Pain – What is it?  What is its purpose?

It was found that working with pain could be broken down into 2 main thought patterns:

 “Working with pain” in labor approach versus a “pain relief” approach.                


            What is its purpose?  Long term benefits of pain in promoting normal birth in terms of women’s experiences and lives.  Pain plays an important role in how this works.

  1. In the beginning, pain alerts a mom that her baby is going to be born soon, and to secure a safe place.  She should gather people around her that she trusts and can help both her and her baby.
  2. As labor continues, the pain triggers a cascade of neurohormones that control the process.
  3. The pain changes and shows that labor is progressing as it should.
  4. That pain marks the enormous change that is occurring in a woman’s life – her transition to motherhood;
  5. Complex hormones and chemical changes help prepare her to welcome her baby.
  6. Her joy at becoming a mother can be heightened by the contrast with the pain of labor together with the sense of achievement and triumph at the completion of a huge and challenging task.


Secrets to a Peaceful Labor:

                  Remove Fear -  Educate yourself. Stay calm through focused breathing, massage, essential oil therapy.  When labor is progressing normally (when contractions are normal and the baby is well positioned), with support and encouragement, women are able to cope with the pain they experience. 

  1. This is due to the production of the body’s natural pain relieving opiates, endorphins.
  2. An atmosphere of quiet, peace, avoiding any procedures or environments that inhibit the production of endorphins.
  3. When a women experiencing normal labor is offered medication for pain, she will find it irresistible, as labor involves both pain and uncertainty.


               Treat Your Body with extra loving care – prepare for birth by choosing ways to keep baby in the optimal fetal position, eating to keep baby the perfect size, stretching, exercising, walking, practice stress-free living.


               Choose your birthing entourage carefully  – Make the right choice about where to have your baby. Where do you feel safe?  Communicate your birth wish list with your care providers and those who will be supporting you. 

               Uninterrupted birth – set up your birth environment, by removing distractions during labor and birth.  Choose lower lights, minimal visitors, reverence the birth-work of mom. Keep voices hushed and small talk outside.


                Listen to your Body – What feels most comfortable?  Standing and walking, side-lying, hands and knees?  Resting in bed with a back massage.  Work with your body to bring baby down.


 Reasons to consider a more natural birth:

                 #1  We want the healthiest choice for our baby and ourselves

                 # 2  We want our baby to be born medication- free and alert

                  #3  We want to be an active participant and experience the natural high that comes with birth

                  #4   We want to use movement as the best way to manage labor

                  #5  We want to get the highest level of oxytocin ever.

                  #6 We want to avoid unnecessary interventions

                  #7 We choose a faster recovery and easier start to breast-feeding

                  #8  We want our partners to be totally connected to the process


    Common Reasons a hospital birth or labor/birth with medication is chosen:

  1. Because they or their partner or family are more comfortable with the idea that high level emergency care is immediately available, if something should go wrong.
  2. They have medical conditions that create a pregnancy and birth that is not  “low risk”.
  3. They have pain experiences ( emotional, physical pain or abuse) that lessens their ability to cope with labor pain.  They are afraid that they will not be able to handle the pain or senstations.
  4. They cannot financially afford out-of-birth care or their insurance does not cover out-of-hospital care.  Or their insurance does not cover a midwife.  No midwife in their area.
  5. Belief that a hospital is “sterile” and safer than the home. Or don’t have to worry about cleaning up  after a birth. 
  6. They feel that a c-section will be easier than going through labor
  7. My first birth was very challenging or I had a c-section and I am not able to birth normally
  8. Safety (barrier) from unwanted visitors
  9. Transport to hospital from a home or birth center birth, due to problems arising.


            What do most birthing women want?   – Listening Mothers Survey 2010

  1. Continuity of care – same care giver that does her prenatals, is the one who delivers her baby.

       2.   Emotional Support – Support has a major impact on how women cope with pain in labor.

                A Cochrane review of continuous support for women in labor concluded that emotional support, comfort measures, information and advocacy may enhance normal labor processes as well as women’s feelings of control and competence, thus reducing the need for intervention.

In early labor, when the majority of women are at home without a professional support, comfort and encouragement from family members, a friend or doula is important.

             Without support women are more likely to go to the hospital before labor is well established and to have epidural for pain and other intervention.

               Once admitted, a birth companion of doula continues to play an important role, offering love, reassurance, praise and sometimes acting as an advocate for your birth plan.

          3. Privacy and a safe, protected birth environment.

          4. Natural and low-technology comfort aids.  Minimizing outside distractions


Evidenced based working with pain measures

  1. Water immersion such as using a birth pool or bath tub or Jacuzzi
  2.  Active movement (change position every 20 minutes)
  3. Ability to eat and drink during labor
  4. Privacy and non-interrupted place to labor
  5. Relaxation, no fear and no tension.