Birth pains include all types of pain caused by them before, during and after birth. These include, for example, the so-called sink pains, which occur weeks before birth, the contractions immediately before birth itself and the pain during birth caused by the stretching of the uterus and the expansion of the birth canal (cervix) and vagina by the child. After the birth, women suffer from afterbirth (birth pains) because the uterus contracts again and expels the afterbirth (placenta), and from pain in the entire intimate area and in the vagina because injuries and tears can easily occur during birth.
Under certain circumstances, a so-called episiotomy must be performed to facilitate the birth to widen the vaginal outlet, which can also be very painful and whose scar can also cause pain after birth (see: Episiotomy scar). These manifold birth pains of different causes can be reduced or even eliminated in just as many ways. The possibilities and risks are described below.
Frequency
Straight Erstgebärende suffer above all before and during the birth from often substantial pain (birth pain) in a study to the topic birth pain the average value of the Erstgebärende women on a pain scale with the maximum value of 50 points was nevertheless with 38 points. Through regular participation in antenatal gymnastics and prenatal classes, the mean value of the birth pain of first-time mothers could be reduced to 32 points, which corresponds to 15 – 20% relief.
Causes
The pain (birth pain) before, during and after a birth has very different causes. The earliest occurring birth pains are often the so-called sink pains. These occur in the last few weeks before birth and are strongly pronounced in each woman individually.
At this time, the baby has usually already turned, so that the head points in the direction of the birth canal (skull position). Now the baby is pressed by gravity with the head deeper and deeper into the woman’s small pelvis. In the process, forces act on the uterus and the cervix (cervix uteri).
At irregular intervals, more or less severe pain (birth pain) occurs. A normal birth begins with the opening phase. It manifests itself with irregular contractions (4 – 6 contractions per hour), the contractions cause a shortening of the cervix uteri and a dilation of the cervix.
The contractions come in shorter and shorter intervals, are more painful, possibly the amniotic sac bursts and the contractions are accelerated, this is the so-called transitional phase. When the cervix is almost completely open (8 – 10 cm), the expulsion phase follows. The contractions (birth pains) come at very short and regular intervals (24 – 28 contractions per hour, i.e. just under every two minutes) and are very intense.
Due to the increasing pressure in the lower abdomen, the woman feels the need to push along and support the contractions. When the baby’s head is born, there is usually a short pause in labour, followed by the shoulders and then the baby’s body. This is followed by after-birth contractions to expel the after-birth (placenta).
The midwife or obstetrician checks these for completeness. If small parts are missing, they must be removed by hand (manually) or a scraping must be performed (risk of infection and adhesion). During a contraction, the wall of the uterus contracts (contraction).
This contraction runs away from the cervix in the direction of the mother’s heart, thus pressing the fetal head or the preceding fetal body part into the mother’s pelvis in the direction of the cervix uteri, opening the cervix. Since strong forces act on the uterus and cervix uteri as a result of the contractions (birth pains), pain (birth pains) occurs during the contractions, which are differently pronounced in all women. The emotional state of the woman in labor has a great influence on the duration and intensity of the contractions. If the woman is relaxed and fearless, the birth usually does not take as long and is less painful than in tense and anxious women.With the help of breathing and relaxation techniques the course of the birth can therefore be positively influenced, the cervix opens more quickly and less painfully (birth pain) and the birth is easier.
