2nd time natural birth moms: I need some advice re: pain management
agent79@me.com
member
Hi there,
So I've been on the fence about using pain medications, but am pretty convinced now that using them is NOT ideal, and will lead to unnecessary interventions.
My fear is that by not knowing what to expect in terms of pain and pressure, I will become SO anxious that I tense up and everything gets worse. Also, when I'm anxious about things I tend to experience much more pain than when I'm calm.
Can anyone help me out and detail what to expect from active labor, transition, and pushing? I mean, what type and level of pain should I expect for each?
I think if I have that explained to me, I'll cope much better and know what to expect, preventing me from freaking out and demanding pain meds. 
Sorry to be such a worrier, but I appreciate any advice.
Re: 2nd time natural birth moms: I need some advice re: pain management
I've dealt with high-pain situations since adolescence (migraines, intense menstrual cramps that felt like the first half of labor, root canals & tooth extractions, etc. No broken bones, thank God.) So, my pain tolerance is higher than some, although I prefer the pain of labor over a migraine. At least it has a purpose, right?
With that in mind, I will try to explain "my" labor experiences in short form. I typically keep in mind that I'm dealing with more "pressure" than "pain", although there IS pain. At 4 cm dilated, I'm around a 3 on the pain scale. Pitocin typically makes the pain a bit more intense, but I was still able to deal with it because my DH is an EXCELLENT support. Having the right support person makes ALL the difference in the world. I had too many people in the delivery room with my first 2, and I believe that added to my desire for meds because I couldn't concentrate on my DH. (My first was a Pit induction, sooo...)
The pain usually gradually moves to a 10 at transition, with extreme pressure. (If you've dealt with constipation, then you've dealt with a similar pressure...one that you shouldn't push against, but allow to naturally progress.) That was always the point where I told DH I couldn't do it anymore, and he would remind me that I WAS doing it. My pain level went back down to 7 or 8 at the pushing point, because I was able to DO something. (I hated hearing "don't push yet". Especially from a male doctor who has never had to "not push yet"...unless he's dealt with the worst constipation EVER.
) As baby crowns, there's a "ring of fire", but with gentle massage by a nurse or doctor, it's not so bad. You usually need to "pause" so they can get the shoulders where they need to be, but that's just a second or so. There's an immense feeling of relief once baby is out. The placenta is next, but I hardly noticed that, since I had my baby on my chest distracting me. 
So, considering the fact that my labors and deliveries have been rather smooth and complication-free, and I have small-ish babies (7#2oz & less), this ^^ is what labor feels like to me.
Even with Pitocin supplementation during my 3rd labor, I was able to go pain-med-free thanks to my DH knowing how desperately I wanted that and supporting me through the whole experience. I don't think I can properly express how important it is to have that support. It absolutely made THE difference.
I hope this is helpful to you. I agree with PP that reading others' birth stories is helpful. Knowledge, faith in yourself, and support. My 3 coping mechanisms.
You will know what your labour will be like once it's over.
There is just no way to predict it.
Having said that, my second natural labour/delivery was quick. I noticed contractions around midnight, they were 3-5 minutes apart, not very strong and felt short in duration. Prior to noticing the contractions I had the urge to empty my bowels constantly for over an hour. Honestly, I was going to the bathroom every 5 minutes for a bowel movement, even after there was nothing there.
Anyway, after about 2 hours of contractions I decided to go the hospital just in case. I suspected a quick labour (1st was 9 hours start to finish and that included 2 hours of pushing) and didn't want to be caught at home. My water had not broken, even though that was the first sign of labour with my first.
I got checked out as soon as I arrived. Confirmed contractions were real (and reading much longer and stronger than I was perceiving them) and I was 7-8cm. As soon as she said that (2 nurses checked me out because the first thought for sure she wasn't measuring me right) I hit the transition.
15 minutes of hell. Honestly, contractions on top of each other, extremely intense, felt like I couldn't catch my breath. I remember thinking "this is an unreasonable amount of pain".
Near the end of the transition, my water broke. Shot out of me like a garden hose, lol. Then I announced to the ER doc (the on call doc had yet to arrive, it was the middle of the night) I was going to push. Pushing felt good. I pushed 3 times and my 8lb 8oz baby boy was born. Placenta delivered 5 minutes later.
I walked in the hospital about 30 minutes before my son was born.
I was trying not to count on a fast labour, but it happened. I'd take that 15 minutes of transition over in a heartbeat and wish my labour/delivery on anyone.
Contraction pain: 2-4 (out of 10)
Transition pain: 9
Pushing pain: 2 (2nd degree tear and a bunch of stitches)
My labor started with time-able contractions that woke me from my sleep. In the beginning I would have a stronger contraction followed by a break and then a weaker contraction (I called them mini-contractions). It would just keep repeating like that. I estimate I was getting a 4-5 minute break between them. I know in the earlier stages of labor some women like to keep busy, but for me the key was to find the rhythm of my labor and rest between contractions. For me it felt like a twisting tightening feeling that started in my stomach and wrapped around my back. Also during this time I had loose stools and started having my bloody show (don't know how much information you wanted, but you said you wanted to know what to expect
Pain level at this time was probably a 4.5.
As time went on my 'mini-contractions' disappeared and they were all stronger contractions. They started to get closer together, but I was still having about a 2.5 minute break in between. During those breaks I felt pretty good, but did my best to stay still and rest. Also during this time I started to feel a little nauseous, but not to the point where I really thought I was going to throw up, just mild nausea during the contractions. Pain level: 6
When we arrived at the hospital I was at 6cm, so I'm guessing transition started soon after that, but I didn't really experience what most women do I guess. My labor just sort of flowed from one contraction to the next getting more and more intense, and closer together, but never that dramatic change. My contractions never got really close together, I always had at least a minutes break between them, sometimes as much as two. As time went on I felt stronger and stronger tightening and also started to feel pressure. They checked me and I was fully dilated, but my DD was only at zero station, so I decided to labor her down before pushing. I waited another 1.5 hours and started to feel more pressure, they checked me again and said she was at +2 so I decided I was ready to push. (Pain level 8.5)
Pushing was a relief, the contractions were barely noticeable because I was so busy pushing. (Pain level: 5) Pushing is hard work, but a lot of women find it to be a huge relief. The only part that I would really describe as being unbearable pain was when her head was crowning, the 'ring of fire' is appropriately named! (Pain level: 10) Then her shoulder got stuck which was the only time I made a peep. But this was the only part that was really and truly bad, everything else was manageable.
The placenta passed easily, I barely noticed. After I had her they were massaging my ute which is highly uncomfortable, but not awful. If you are planning to BF that will bring more contractions (more similar to menstrual cramps).
Wow, thanks ladies. I really appreciate the stories and advice.
I'm going to get Ina May's book and read up on more childbirth stories, and practice more pain coping methods. DH is a great support person, so I'm lucky...
The situation will really hinge on 2 things.
#1 How fast everything is progressing - If you are having a fast delivery it can get overwhelming becuase there's no rest. I almost caved with DD because I went from 0-10 cm in less than 3 hours but no one had checked me. I thought I still wasn't dialated at all and was panicking. I'm sitting there thinking, there's no way I can do this for 12+ hours but it turns out that I didn't need to.
#2 - How relaxed you are - Also with DD, the place I was at was really not natural friendly. They gave me a hard time and kept trying to scare me and threatening C-section. I was no relaxed. I was scared to death and labor hurt bad. With my twins it was a whole different story. I was relaxed, singing along to my music. The doula and DH were rubbing my arms and head during contractions and I was in a rocking chair instead of strapped to the bed. It was like night and day. It hurt towards the end. But it was manageable.
Trust that you can do it.
I would definitely suggest practicing relaxation by listening to some audio tracks (like Rainbow Relaxation and birth affirmations). That will really help... at least it did for me. If you can take a natural birth class (like Bradley or Hypnobirthing), DO IT. I did for my first and it was priceless. I felt so much more confident about a natural birth after taking a Bradley course.
In terms of the pain, it will vary from person to person. For me, a contraction feels like a bad Charlie horse around my midsection once active labor starts. In early labor, it feels like a really strong period cramp. I never noticed a "transition" period. I was just focusing through contractions and, next thing I knew, my body was starting to push with contractions. I made sure to breathe through each contraction and take it one at a time. Vocalizing my way through (moaning/"singing"/whatever) also really helps me. In between contractions, it was like a total rest. I could go back to a conversation, make jokes or whatever, although I was winded because you feel like you're running a marathon.
Also, I was able to labor in the water which is AMAZING. If you can do that, I highly recommend it. I used both a bath and a shower and, ultimately, a combination of the two (my midwife kept having to periodically drain the tub down so it wouldn't overflow because I was laying in the water with the shower head running over my abdomen). You will find what works best for you when the time comes though. It's honestly not that bad; just takes a lot of mental endurance.
ETA: And, for me, the hardest part of the whole thing in terms of pain is crowning. But then you know you're within minutes of meeting your little one. You just really have to breathe and let your body do it's thing at that point but then it's all over just like that.
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three