How Painful Is Childbirth?

How Painful Is Childbirth?

How Painful Is Childbirth?
By Jennifer Vanderlaan

There is an expectation in the United States that childbirth is the worst pain you could ever feel. Because of this, women approach childbirth with overwhelming fear of the pain and attempting to remove it all in search of a good birth experience. How painful is childbirth really? What does it take to handle the pain? Can you have a good birth experience if you feel pain?

How painful is childbirth, really?

Ronald Melzack researches experiences of pain, and studied the pain of labor. Through his research he found that overall childbirth can be called severely painful, but the intensity of the pain is variable. About 25% of first time mothers and only 11% of experienced mothers rated labor as horrible or excruciating. In fact 9% of first time mothers and 24% of experienced mothers said they had low levels of pain. With 17% of women having low levels of pain, the “easy” labor can’t possibly be as rare as we think it is.

For many women labor is the first experience with any real physical pain. Women who have experienced other physical pains tend to rate childbirth lower on the scale than things like kidney or gall stones, Lyme disease, chronic back problems, some broken bones, double ear infections, toothaches in need of root canal and recovering from cesarean surgery. Some women even claim the pain of labor is easier to handle than the pain of a broken heart. The point is, how painful childbirth feels is somewhat relative. Without another pain to compare it too, calling childbirth the most painful experience is prejudiced.

If only 18% of mothers rate labor as excruciating, how likely are you to be included in that group?
Research by Lederman found that overall, you are likely to experience more intense pain if you:

  • Are a first time mother
  • Have less education
  • Are younger
  • Experience menstrual problems
  • Have a history of miscarriage
  • Have difficulty accepting this pregnancy
  • Feel conflict about becoming a mother
  • Are anxious about labor
  • Fear being helpless, in pain, losing control or losing self-esteem
  • Have a previous psychological issue requiring counseling
  • Have unstable emotional feelings
  • Have unrealistic expectations of the pain
  • Have a partner who is negative or indifferent toward this pregnancy

What does it take to handle the pain?

One of the most startling truths about the pain of labor is its relation to the mother’s confidence in her ability to cope. In general, the more confident you are you will be able to cope, the less pain you will feel. Another important factor is the people you have with you at labor, because your ability to cope with the pain of labor will be influenced by the interactions you have with those attending you (midwife, doctor, nurse). This paints a far different picture of what you will need to get through labor than the old “high pain tolerance” theory. In fact, you can be a wimp about pain and still cope well with labor pain.

In A Wise Birth, authors Penny Armstrong and Sheryl Feldman explain that women who are treated well by birth attendants, have their needs considered and bodies respected and whose mothering responsibilities are honored will give birth more easily. In contrast, women who are challenged by their birth attendants, restrained, distrusted and treated indifferently will have more trouble with labor. They conclude, “drugs and technology in birth, as in life, have proved to be poor substitutes for true, human attention.”

Studies on doulas continue to prove their statement correct. A doula is a professional childbirth assistant. She does not offer medical help, instead her job is to simply be with the mother and serve any needs she may have. You may find a doula rubbing a back, suggesting positions, teaching a partner how to give a massage or just talking to the mother. What effect does this attention have? Women with doulas need less medical intervention to give birth, are less likely to need medication for pain, and are more satisfied with the childbirth experience. Again we see a high pain tolerance is not what it takes to cope well with labor.

Can you have a good birth experience if you feel pain?

Not only can you cope well if you are a wimp about pain, but you can have a great labor and be satisfied with the experience even if you feel pain. In fact, in one study, the mothers who refused anesthesia felt more pain, but they had higher scores of satisfaction with labor both immediately after the birth and one year later. Another study found no difference in satisfaction immediately after birth, but within two days mothers who had chosen to use epidurals had less positive feelings about childbirth. All of this tells us that removing the pain is not related to having a good childbirth experience.

Where does all this leave you? There are several things you can do now to give yourself the best chances for a low pain labor and positive birth experience. First, educate yourself about the process so you are less likely to be anxious and fearful of what to expect. Second, learn different techniques for working with your body and managing the pain you feel in labor. Third, make sure your caregivers will be supportive of you during labor – if they won’t or can’t, hire someone else. Finally, hire a doula to be with you during labor. These four things will give you the best odds for a manageable labor, regardless of how painful it is or is not.


Melzack K, Taenzer P, Feldman P, Kinch R, (1981). Labor is Still Painful After Prepared Childbirth Training. Canadian medical Association Journal, 125:357-363.
Lederman R, Lederman E, Work B, McCann D. (1979) Relationship of Psychological Factors in Pregnancy to Progress in Labor. Nursing Research, 28(2):94-97.
Lowe, N.K. (1993). Maternal confidence for labor: Development of the Childbirth Self-Efficacy Inventory. Research in Nursing and Health, 16(2) 141-149.
Standley K, Nicholson J (1980). Observing the childbirth environment: A research model. Birth and the Family Journal, 7, 15.
Armstrong P, Feldman S. A Wise Birth. London:Pinter & Martin, 2007.
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C, (2003). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2003 Issue 3.
Morgan B, Bulpitt CJ, Clifton P, Lewis PJ, (1982). Analgesia and satisfaction in childbirth (The Queen Charlotte 1000-mother survey). Lancet, 1, 808.

For more information about the pain of labor, and to learn effective ways to cope with the pain, Jennifer invites you to visit Jennifer Vanderlaan is a childbirth educator and doula who helps families discover what they need to be successful at childbirth.

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