Pain in Childbirth – Part 2

father in delivery room

What contributes to PAIN in labor?

Fatigue

Muscles that are stretched, hurt. The muscles of the uterus work faster, the blood and oxygen flow is lessened. When there is tension, the uterus works even harder and fatigue sets in. The tension of the surrounding muscles has created a “brick wall”. So, relax.

Tension

The stretching of the lower uterine portion and the intense contractions of the upper uterine muscle are what is thought to be the source of the pain felt. But these muscles actually have very few pain receptors. You would not feel the pain unless the muscles were forced to work in an unnatural manner. If tense and fearful the nerve endings of the muscles and tissues around the uterus send messages to the pain receptors. There is a direct correlation of tension to pain.

Tired muscles

The biochemistry of the muscle is imbalance when tired. It creates tension that sends out more electrical activity. The physiological changes will lower the point at which the muscle will hurt.

The outlet is too small, or baby too big

These actually do not need to be an issue. Usually the position of the baby or laboring mother, are the causative factor of pain. The pain messages are signaling that something isn’t right. What will help is a change of position of the mother.

Get out of the horizontal position, to a vertical one, and things will change. The baby is assisted (most of the time) to re-position him/or herself in the womb to facilitate birth without as much pain. As stated in a different hand-out, just doing this type of change in position opens the outlet by 20%.

Fear

Information is out there on all the things that “can go wrong”. We are not taught that birthing is a natural process; we women are pummeled with media and other females telling horror stories about birth.

There is a shroud over the whole process of birth, making it seem to be a great mystery. What is needed is correct information.

Your uterus is a magnificent muscle which is affected by the neuro-hormonal pathway that connects the brain, the circulatory system and the uterus. Fear causes an alteration of the pathway creating a reduction of blood and oxygen to the brain. This results in the tightening of the cervical opening of the womb.

Fear unbalances the hormones of the body. Being fearful causes the release of labor inhibiting hormones. These are the stress hormones of the adrenal glands that when in stress, we release hormones that are the fight-or-flight mechanisms. Animals also have them, and the hormones are released to stop labor allowing them to find a safe place for birthing. These then block the labor enhancing hormones . This lengthens the labor and increases the pain felt.

A well-informed, correct education about birthing will assist you. Make sure your labor supporters also have been educated so that their fear is not surrounding you when you are in labor.

Occasionally, the sensation of pain will continue, even after all the relaxation techniques are implemented. This may be due to a tightened psoas muscle or mal-aligned hip. Both can cause tension in the body, and / or problems with the baby being delivered easily. These two issues can be checked, and remedied.

The Natural Pain relieving Narcotic: Endorphins

“Circulating throughout the body are natural hormones that relax you when stressed and relieve pain when you hurt (138)”

What is sad is that most women do not know about these hormones, or that they can activate them when needed. In the 1970s studies were being done for drug addiction and the presence of these hormones in the receptor sites of the brain (for morphine-like substances). What was found was that the nerve cells that are attached to receptor sites, had chemical pain relievers that acted to dull the sensation of pain in the cells. Here is how they can work for you:

As you probably know, Endorphins are raised during exercise and well, labor is strenuous exercise!

  • When the abdomen contracts in labor, the Endorphin level is raised.
    o This is especially true in the second stage of labor.
    o They are the highest after labor, and two weeks beyond.
    Endorphins are highest during vaginal birth, not so much when labor was started but delivery was cesarean.
  • Endorphins are higher in newborns that had signs of fetal distress during their delivery.
    o Baby also receives Endorphins during birth.
  • The release of Endorphins also will stimulate the production of prolactin, the hormone that relaxes and creates the “mothering” sensation.
    o Prolactin regulates milk production, which boosts the interaction with baby and mother.
    o These hormones are what researchers think are the cause of the “birth high”.
  • Mothers who had surgical birth have lowered hormone levels, which would account for the delay in milk supply after cesarean birth.
  • Endorphin production is directly tied to a person’s emotional state.
    o So if stress and anxiety are not resolved the body increases the stress hormones, Catecholamines, which counteract the relaxation produced by Endorphins.
    o Like commercial narcotics, Endorphins may behave differently woman to woman, which is why some women may feel more pain than others.
  • Injectable narcotics give you a bit of blast of pain relief, whereas Endorphins give you a steady dose throughout labor.

Women in labor are very aware of the natural hormone effects and describe the experience as a “natural high”.

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