What Hurts More, Contractions or Pushing?

Do women lie about childbirth pain? Here's how to get the lowdown on what labor and delivery will actually feel like, so you can go in fully prepared.

What Hurts More, Contractions or Pushing?

Hillary emailed with a subject title reading, "I think my mom is lying to me." She's in the "planning to plan" for a pregnancy stage (AKA—not pregnant—never has been). She was chatting with her mom about all that goes into having a baby and asked about her own birth. Hillary's mom was apparently a "natural woman" and didn't have an epidural.

Here's the pickle: Hillary thinks her mom is lying about what hurts most, where and when during labor and birth. Mom says contractions hurt more than pushing. Hillary says, "I told my mom in no way could that be true, but she told me that by the time one is pushing, your perineum is so numb from the pressure that you barely feel it! She said she either tore or had an episiotomy, and didn't feel that either! I can't believe her! How can pushing a six-pound human out of the vagina hurt less than contractions?"

Whooo! That's a mighty strong opinion about a really subjective experience, Hillary. You've never had a baby and you're calling your mom a liar? Have we got some mother/daughter dynamics going on here or what? I'm teaming up with your Mom on this one. Here's why: For most women, labor is more painful than pushing because it lasts longer, gets gradually (or rapidly) more intense as it progresses and involves a large number of muscles, ligaments, organs, nerves and skin surface. Everything from the breast/rib area down works hard, contracting as tightly as possible for one minute out of every two or three for hours. Pushing goes a lot quicker.

With no epidural or narcotics on board, most women rate active-phase labor a 10 on the pain scale of one-to-ten. With good pain management techniques taught in childbirth education, breathing, relaxation, massage, hypnosis and other methods that were (and still are) popular when you were born, most women can lower that number a lot. Epidurals decrease pain dramatically, in some cases all the way to zero. It's totally subjective though. I've had a few patients say labor doesn't really hurt. Far more however, say it hurts like hell.

By the time you're ready to push and the baby presses into the birth canal, most of the work is done. Baby's head presses on nerves that desensitize the pelvis and many women report feeling kind of numb. Some (I've never actually met any) say it even feels good, similar to orgasm. Pushing is often a relief because it's a natural urge they can give in to. It's active, not passive. They can finally do something to get baby out. Mother Nature figured this out because otherwise, nobody would be willing to push and we'd be pregnant forever.

I wish I could say this is every woman's experience but again, pain is entirely subjective. We're all individuals with our own nervous systems, brain chemistries, personal experiences, etc. It's not for us to judge what is painful to other people.

One final note, Hillary. Birth and parenting are never what you think they're going to be before you experience them. Try not to hold too tightly to your own opinions and expectations until you know firsthand what you're talking about. It's one thing to plan on planning to have a baby. It's another thing entirely to have had and raised one. Your Mom gets this point.