During the second stage of labour, pain may not be as predominant a feature for some women. It can be an immense relief to give into the powerful pushing urges.
As the baby's head starts to emerge, you may feel intense burning and stinging sensations as well as the feeling that you are going to rip apart. Fortunately, the female body is admirably well built to stretch and accommodate the baby's head without tearing.
Postpartum pain usually depends on whether or not an episiotomy was performed. This is a surgical procedure in which a cut is made to enlarge the vaginal opening for the baby's head. Small vaginal tears heal quickly and without pain.
Women who have a "back" labour feel the contractions as an intense aching in the low back area, and may have to take special measures to cope with the pain. Strong pressure on your lower back by your partner and/or frequent changes in your position (a hands and knees position may relieve the pressure best) are often helpful.
Finally, pain in childbirth has two essential characteristics which make it very different from other types of pain you may have experienced.
Firstly, it is a creative and rewarding kind of pain, in that, whether by vaginal or Cesarean birth, it results in the birth of a child.
Secondly, it lasts for a distinctly limited amount of time, usually not more than 24 hours, with a much shorter period of hard labour.
Moreover, if the question of pain is faced squarely in the prenatal period, you and your partner will be able to develop realistic and positive strategies for dealing with pain.
Just as you plan ahead of time what items to bring in your suitcase for the hospital, so you should select tools or strategies for coping with pain well in advance of labour.
If left on your own during labour, you would naturally adopt a rhythm and style of breathing exactly appropriate to your labour. However, as part of your bag of tricks, you should be familiar with at least three different types of breathing, deep breathing, any pattern of pant-and-blow breathing, and second stage breathing.
These breathing types can be learned in most prenatal classes or through books, audiotapes or videotapes.
However, neither you nor your labour coach should adhere too rigidly to any breathing type. Your partner or labour coach can assist you by breathing with you, and making verbal or non-verbal suggestions as to when to change to a different type of breathing.
Especially important during second stage is to keep your mouth open and relaxed. If your mouth is relaxed, your vagina is automatically relaxed.
This is the other essential skill needed for labour. The key is learning to relax under pressure. During pregnancy there will be ample opportunities to practice. Specific relaxation techniques are described in the chapter How To Cut Down On Stress.
A change in position is often highly useful. Lying on your back is probably the worst position for labour. Studies have shown that if you walk for as long as possible during the first stage of labour, you will speed up the progress of labour due to forces of gravity. While in bed, you can lie on your left side, sit upright or semi-upright, or go on your hands and knees.
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