Moaning, screaming, and cursing. These are some of the pleasant sounds commonly associated with childbirth.

You’ve likely seen birth graphically depicted on television, or if you’re pregnant, all of your family and friends may have decided to share their harrowing birth stories with you. If you’re like most women, this has led to a lot of fear about the amount of pain you’ll face during labor.

Is this really the truth about birth though? How much pain will you actually experience? Can you do anything to diminish that pain? While birth is different for everyone, we’ve got the information, tips, and tricks to help you feel prepared for the pain of childbirth.

Every person’s experience with birth will be different. Pain is subjective and can vary greatly. This means that you may have a very different pain experience from even your mother or sister.

It’s important to remember that the pain of childbirth is a manageable one, and both medicated and more holistic pain relief measures like visualization and massage are available.

Despite what you may have seen on YouTube or elsewhere, there’s no reliable unit to measure pain. Back in the 1940s, researchers tried to employ a device known as the dolorimeter, which used the heat from a light source, to establish levels of pain.

However, this measurement fell out of favor with growing evidence that pain isn’t solely dependent on an isolated physical sensation. Rather, it’s affected by a person’s fears, mood, memories, and personality, as well as factors like the duration and overall experience of the pain source.

Your healthcare provider will likely ask you to track and quantify your pain by rating it on a scale. They may discuss the intensity of the pain and your feelings about your ability to work through or manage it. This information will help them determine the appropriate pain relief options with you.

Pain is not necessarily consistent during the labor process, and you’ll probably experience breaks from it between contractions or while pushing. Although, you may notice though that it increases after your water breaks or as labor picks up, and that some elements of the pain are temporary while others continue for a period of time after giving birth.

When you think about the pain of childbirth, just remember that it’s purposeful, anticipated, intermittent, and a necessary part of your baby coming into this world!

You can expect to experience a variety of sensations during the end of your pregnancy and labor.

During pregnancy, you may experience Braxton-Hicks contractions, which are usually irregular and inconsistent. They tend to be felt in the abdominal area and make the belly feel tight, causing discomfort more than pain.

One thing that sets these contractions apart from labor contractions is that they don’t become more consistent, stronger, and longer. (If you would like to reduce the discomfort of Braxton Hicks, you can try drinking some more water, changing position, or resting on your left side.)

Early labor

In the early stages of labor, contractions will increase in intensity and frequency as they fall into a steady pattern.

Early labor contractions will usually cause the abdomen to feel tight to the touch. You may also experience a dull backache, feelings of pressure in the abdomen and pelvis, and sensations similar to those of intense menstrual cramping.

When contractions begin, they may only be 30 to 45 seconds in length with several minutes of rest in between.

Active labor

As labor progresses, contractions may feel like they are wrapping around your body from the back to the front. You may also begin to notice cramping and discomfort in your legs as the contractions become more frequent and last closer to 1 minute in length.

When you’re approximately 8 centimeters dilated, you may have 30 seconds to 1 to 2 minutes between contractions as you prepare to enter the pushing stage of labor. During this time it’s not uncommon to feel lightheaded, nauseous, and have hot flashes or chills.

Pushing

When you are fully dilated (around 10 cm) and it’s time to push, you may feel an intense pressure that feels like you need to poop. You can relax a little knowing that your body is just telling you that it’s ready for you to help push out your baby.

During this period, you’ll typically be instructed to push with the peaks of your contractions. Because you’re pushing with the contractions, many women find these contractions less painful than the contractions helping them to dilate.

Other parts of the experience may also cause discomfort or pain, including an episiotomy or vaginal tearing. You may also feel muscle pain or fatigue from pushing or experience uncomfortable side effects from medications used during labor.

If you’re feeling nervous about giving birth, there are things you can do before and during labor to decrease your pain (and increase your chance of having a positive birthing experience!).

Before giving birth

Exercise frequently

While you may need to modify your normal exercise plan, it’s worth continuing to exercise during pregnancy. Regular exercise during pregnancy not only helps control your blood pressure, mood, and weight but also can help keep your body in shape for the work of labor.

Take a birth preparation class

Knowing what’s ahead can help you relax and feel more comfortable during labor. Most birth preparation classes include instruction on comfort measures during labor, so you and your partner can get ideas and practice before the big event. (While you’re at it, you may also want to sign up for a baby care or breastfeeding class!)

Eat well and take your prenatal vitamins

It’s important to put the right nutrients in your body to help your baby grow properly and give yourself energy for labor.

Consider optimal fetal positioning

It’s easier to birth your baby when they’re in an optimal position. If your baby is breech or transverse, you may want to consider actions that will encourage them to shift their position… before you go into labor!

During labor

Pain relief during labor is a personal choice. You can try any combination of the following methods.

Breathing techniques

Whether you choose to follow a particular breathing routine during labor or just need to do some low vocalizations to help you through the more intense contractions, focusing on your breathing can help you manage the pain.

Water

Even if you don’t want to give birth in water, spending some time in a shower or bath can help relieve the pain of childbirth.

Being in water has been found to be particularly effective in the first stage of labor. It can help relieve both pain and anxiety. If you have access to a moveable shower head, aiming warm water directly onto the lower back may feel especially pleasant.

Massage and counterpressure

Many different types of massage can help manage pain during labor. Foot, hand, back, and shoulder rubs may all appeal to a laboring woman. One study from 2010 found that a 15-minute massage each hour during labor helped alleviate pain and was even associated with shorter labor.

Additionally, perineal massage can help protect and prepare the perineum for the stretching involved in birthing a baby.

In addition to massage, many women enjoy pressure being strategically placed on parts of their body to help counteract the discomforts they may be feeling.

Music

Music can lower stress and blood pressure. It can also improve your mood! But can it really help with pain during labor? Yes — a large meta-analysis found that music interventions helped alleviate pain and anxiety during labor.

Visualization or hypnosis

Guided imagery, hypnotic tracts, and other visuals can all help relax a mother in labor and relieve pain.

Movement

Walking, rocking on a birthing ball, or even slow dancing with your partner can help labor progress and relieve some of the discomforts you may be feeling.

Experimenting with different positions, including sitting, standing, or squatting, may also help reduce pain. One study found squatting offered the most pain reduction, but you can experiment with what feels best for you.

A doula

Research shows that having a doula present at your birth can lead to a better birth outcome. A doula can help with positioning/counterpressure, offer suggestions for comfort measures, advocate for your choices, and help answer your questions throughout the laboring process.

Not sure where to find a doula? Start here.

A TENS unit

Many people have found some pain relief during labor by stimulating their lower back with a transcutaneous electrical nerve stimulation (TENS) unit. (Some hospitals even have TENS devices that you can borrow during labor!)

Aromatherapy

If you’re feeling nauseous or anxious, peppermint, lavender, or some citrus essential oils may provide some relief during labor.

IV narcotics

Intravenous (IV) narcotics offer some of the pain relief of an epidural for a more limited time. As in the case of an epidural, nausea, headaches, drowsiness, and the transmission of medication to the baby are potential risks.

For a woman seeking a brief reprieve from the intensity of birth, an IV narcotic can be a very appealing pain relief option.

Nitrous oxide

While you may have seen it during dental visits, in the United States nitrous oxide is less commonly used as a pain relief option during childbirth. It’s a fast-acting option for pain and anxiety relief that doesn’t stay in the system as long as narcotics.

Nitrous oxide has been used for over a century and is generally considered safe for the mother and baby. While it’s used regularly in some locations around the world, you’ll need to check with your provider as to whether it’s available where you’re delivering.

Epidural

The most common pain medication for birthing mothers in the United States, an epidural can relieve the pain a mother is feeling within 10 to 20 minutes. Most hospitals provide epidural analgesia, and if your pain is beyond a manageble level, you can request one.

The vast majority of women who receive an epidural feel pressure and not pain from that point on in their labor. (Many women can even sleep while laboring once the epidural has been placed.)

There’s some risk that an epidural will result in a special type of headache, pushing may be more difficult, your lower half may remain numb for a period of time after giving birth, or you may react to the medication used in the epidural. Still, many women find that the pain relief an epidural offers outweighs these risks.

There’s no way to know exactly what childbirth will be like for you. Even if you have given birth before, each experience is different. Taking steps to prepare beforehand and using comfort measures during labor can reduce the pain of childbirth.

There’s no reason to be fearful about giving birth. While it’s called labor for a reason, millions of babies are born each year. You’re not alone! Your care provider can work with you to ensure that you have the medication and holistic pain reduction measures you need to handle your contractions.