One of the most common questions I am asked is “What do contractions feel like?”
Labour is associated with two different kinds of pain and intensity.
Visceral Pain
The first kind of pain arises from the uterine muscle when it begins to contract at the onset of labour. Because the uterus is an internal organ, the pain associated with contractions is called visceral pain (from viscera, meaning internal organ). Like all sources of visceral pain (e.g. intestinal colic, gallstones, appendicitis), pain arising from the uterus cannot be accurately pinpointed.
Visceral pain is often felt in a different part of the body from where it originated. This is called referred pain. In the case of the uterus, contraction pain is commonly referred to the lower back and sacrum; indeed, some women find that their labour feels more ‘painful in the back’ than in the abdomen. In other words, uterine contractions are typically felt over a large area of the body: namely the lower abdomen, small of the back, upper thighs and bowel. This distribution reflects the nerve supply to the uterus.
Uterine Contraction Pain
Uterine contraction pain is initially dull and aching in character. As the contractions become stronger, so does the pain intensity. The interval between contractions is usually free from pain. Pain referred to the lower back, however, can be felt between, as well as during contractions when your baby is in a Posterior position (spine on spine). There is also some evidence that backache during labour is more common among women who experience backache during menstruation.
Dilation is the cause of contraction pain.
Contraction pain is caused by uterine distension and stretching of the cervix or dilation.
Surprisingly, the uterus can be cut or incised without causing pain. Whether or not contraction pain is caused by the direct stimulation of nerve endings sited within the uterus ( the release of locally produced irritant substances or ischemia – insufficient blood flow, similar to the pain of a ‘heart attack’), is not clear. Several chemical compounds known to produce pain have been isolated from tissues that are injured or unusually stretched. They include such exotic-sounding names as histamine, 5-hydroxytryptamine, bradykinin, substance P and prostaglandin.
Pressure
Whatever the actual mechanism may be, the lower part of the uterus has a rich nerve supply and it is these nerve endings that are stimulated to initiate the sensation of pain during a contraction. Contraction pain can also be caused by pressure of the uterus on surrounding structures within the pelvis, such as the bladder, rectum and nerve trunks going to the lower limbs. (Occasionally, the sciatic nerve itself is stretched – causing pain to radiate into the back of the thighs and legs).
The feeling of birthing your baby.
The second kind of pain occurs during the 2nd stage (the act of birthing). Unlike visceral pain, it is sharp or stinging in character and very accurately localised to the vagina, rectum and perineum. This type of pain is called somatic pain (from soma, meaning body surface) and is due to stretching of the structures of the lower birth canal. It is caused by the descent of the foetus and is later accompanied by a very powerful urge to push or bear down.
So, what do I think contractions feel like?
They can feel like psychological warfare. A war between what you communicate to your mind you are capable of and what you and your body are actually capable of.
They are a catalyst for facing your perceived limitations and smashing you through walls you create for yourself.
They are designed to show you your power and let go of ideas of feminine weakness. They will set you free, liberate and open your body….. if you chose to accept them into your body. The cure for the pain is in the pain.
They will take you beyond this place to an in-between world. You will roar and your eyes roll into the back of your head, you will visit the mystery of the beginning of life itself.
Don’t be afraid of them, they are you
QUESTIONS?
If you have any questions about your pregnancy journey, birth preparation and labour, please don’t hesitate to contact me directly.