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.”

Painless labor is possible but labor for most people has a level of pain 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.

During labor a lot of pressure may be exerted on the fallopian tubes, ovaries, and ligaments. The baby’s presenting part, which is usually the head, presses firmly against your bladder and bowel as he descends through your pelvis. This can lead to great pain, particularly if you don’t empty your bladder frequently. About once an hour is a good rule to remember.

The rectum usually empties itself (“nature’s diarrhea”) in early labor. The pressure of the baby’s head on surrounding nerves will be surprising. This feels as though you are going to have a bowel movement right now. To some women, that feeling of rectal pressure is extremely painful.

When you are in the pushing or second stage of labor, you will probably feel an extraordinary sensation of stretching in your vagina. “I felt,” said one mother, “as if I would burst.” Birth is a normal function of course, but it’s hardly an everyday feeling. When the baby’s head comes down to the vaginal opening, which may happen on the first push, but more commonly takes a half hour or more with a first baby, you’ll feel a sharp, burning sting as the perineum, which is the area between your vagina and anus, stretches to accommodate your baby’s head. In a couple of minutes, the incredible pressure of your baby’s head against the blood vessels and nerves will numb your vaginal opening until several minutes after the birth.

The pain of labor has frequently been likened to the ache and exhaustion of a marathon athletic event. Jacqueline Marcus is an experienced marathon runner as well as the mother of three children. “Every time you run, you think you’re never going to do it again,” says Marcus, “but when you finish, it’s wonderful!. You did that incredible thing. When you give birth, the experience of making a new life is a hundred times the experience of running, but there’s still that same sense of accomplishment, relief that it’s over, and awe. With a marathon, you feel proud that you’ve taken your body through that run. With birth, not only have you taken your body through it, but you’ve got something to show for it. They are both such incredible physical and psychological feats. To be at the end of a marathon race - it’s ecstasy - and so is birth.”

In marathon running (as in childbirth) the runner becomes tired, discouraged, depleted, and ready to give up at some point. Runners call it “the wall,” while childbirth educators call it “transition.” In a marathon race, the wall comes about 20 miles into the 26-mile race. Runners begin to feel queasy, dizzy, and light-headed, and as though they can’t go on with the race.
In labor, the wall may come between around seven and ten centimeters, when the contractions are usually at their strongest and longest, with virtually no rest periods between them. Most women find this tumultuous time during labor exceedingly difficult to navigate. When a marathon runner reaches this point, no one is saying, ‘Oh, you poor dear, don’t you want anesthesia?’ or ‘Do you want to drop out?’ That’s not what they need. They need encouragement to help themselves go on. They get all kinds of physical and emotional support.

Just remember to take each contraction as it comes, but keep an overriding focus on the finish line, the moment of birth. Soon you’ll be holding that precious new life in your arms.

Easing Labor Pain by Adrienne B. Lieberman