Learning more about labor pain during childbirth and how you can reduce it can make you feel more prepared for that big day. The following is an excerpt from the book Easing Labor Pain: The Complete Guide to a More Comfortable and Rewarding Birth.

From the intense, cramping pull or squeeze of the dilating contractions to the profound stretching sensation as the baby's head moves down the birth canal, labor is characterized by powerful feelings. Some women describe the dilating contractions in terms of a more familiar sensation – a cramp, like a menstrual cramp; a charley horse; a gas pain; or a feeling of rectal pressure. One mother says her contractions were like "strong gas pains, tremendous pressure around the pubic area." Another describes labor as "huge waves, like diarrhea cramps, one after the other." Still another says, "My labor felt like extraordinarily severe menstrual cramps with a lot of pressure on the rectum, like constant pressure to have a bowel movement."

Confronting the intensity of pain before you give birth may motivate you to learn ways of dealing with it more adequately when you're actually in labor. In fact, a study published recently in Birth suggests that women with higher levels of fear before their first childbirth class actually reported less anxiety during labor and delivery. The authors concluded that these women probably had dealt with their concerns before they went into labor.

One woman, for example, coped with the pain by envisioning the purpose of each contraction: "I visualized my uterus rising up and pulling back, opening the cervix more and more with each contraction."

Now, painless labor is possible – Alice, who opened this chapter, certainly experienced one – but it's quite rare and should always be considered an unexpected bonus.

Labor is usually painful for several very good reasons. For one, the cervix, completely insensitive to burning and cauterization, is nevertheless extremely sensitive to pressure and stretching – precisely what it undergoes during labor. Most women feel contractions as cramping sensations in the groin or back, though some experience more pain in their sides or thighs. As the contractions get longer, stronger, and closer together over the course of labor, they will be perceived as more or less painful by different women. In addition, the uterine muscle – at term, the largest and strongest muscle in your body – may have to work at alternately contracting and relaxing for hour after hour. That can lead to a tired, achy feeling, just the way the voluntary muscles in your arms and legs might feel exhausted and sore after a difficult workout. The normal decrease in oxygen flow to the uterus as it contracts can add to that achy feeling.

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