Childbirth has arguably been called the most painful thing a person can endure, and with good reason. The pain of childbirth can be both intense and sustained, and can often radiate from several different areas.
Most pain from childbirth comes from the stretching of tissues, including the tissues of the vagina, the cervix and all of the surrounding areas that the baby will pass through. During childbirth, the uterus does not squeeze the baby out, contrary to popular belief. The contractions of the uterus actually pull the muscles of the cervix up so that the baby can pass through. This causes pain in all of those areas, as well as swelling that can be sore and painful for weeks after the birth.
The pelvic area is rich in nerves that respond sharply to both pressure and pain. The pressure of contractions and the stretching of the surrounding tissue is then perceived as pain. Tension of the muscles in that area will add to the perception of pain. The pain from the stretched tissues during contractions sends impulses along the nerves and then to the spinal cord. The spinal cord will stop some of the impulses, and allow others to continue into the brain, where they will be perceived as pain.
Because of the path that pain takes in this instance, it is possible to block the pain in three ways- to stop it in the tissues that are sending the impulses, at the spinal cord, and in the brain. To have the most effective pain control, you will need to control the pain at all three of these areas.
To dull pain in the tissues involved in childbirth, it is helpful to practice relaxation that will keep the muscles from tensing. Finding effective labor and pushing positions to keep muscles from getting tense and tired will also aid in pain relief.
To control pain at the spinal cord, you can employ pleasant stimulus to the spine, such as having a birthing coach massage your spine. Adding some counter pressure to the spine is also helpful for breaking up some of the impulses. Of course, there are medical ways to block pain at this site, including the epidural and the spinal block. Both are an anesthetic that is injected into the spine. With an epidural, the tube is left in the spine throughout the birth, and removed when the pain will have subsided. The spinal block is in injection that will be effective for a set amount of time.
To control pain at the brain level, there are several labor medications that will do this, including Demerol, Nubain and Stadol. These are administered by injections or into an IV that has been established. However, narcotics, as well as both epidurals and spinal blocks, are known to lengthen labor and increase the chances of a Cesearean section. Many people report that tapping into your body's own endorphins can be as effective as narcotics- endorphins attach to pain receptors and will dull the pain. Endorphins can be increased by both exercise and relaxation. The strenuous movements of labor will increase your endorphin level, but tensing up will block the release of endorphins. By keeping your muscles relaxed, the endorphins can be allowed to work.
With many of these pain relief techniques, relaxation is the key. There are several relaxation methods that can be practiced ahead of time and will aid in relaxation during the most stressful parts of labor and pushing. The Bradley Method focuses on relaxing different muscle groups to get the entire body in a relaxed mode. Lamaze focuses more on controlled breathing techniques that can help take the focus away from the labor pain. Either of these methods can be highly effective in pain management during childbirth.