When you think about labour, your first thoughts are likely to be about pain. Thanks to horror stories from friends, dramatic TV births and general trepidation about the unexpected, most mums-to-be fear the pain of childbirth.
Understandably, many women look to their previous painful experiences to get an idea about how they might cope with labour, especially if it's their first baby. But it turns out that cringing at the thought of an injection or popping a pill at the first sign of a headache doesn't put you at the top of the epidural list. Why? Because your pain threshold isn't set to low, high or somewhere in between – rather, pain tolerance during labour can depend on range of psychological factors like perception, environment and education.
"People often use a label of a 'low pain threshold' or a 'high pain threshold', but it can be really unhelpful to go into something like childbirth with that, because it can be changed," says Dr Monique Robinson, associate principal investigator at the Telethon Kids Institute. "Even if you feel like you're someone who can't tolerate pain at all, you can be amazed at your own strength with a little bit of support and the right strategy."
When you feel anxious and fearful, the body produces stress hormones which inhibit the production of feel-good hormones like endorphins. This is often referred to as the 'fight or flight' response – a protective mechanism designed to shield the body from imminent threat.
But because you experience the same response to real or perceived threats, fighting or flighting isn't always helpful. Melissa Spilsted, a clinical hypnotherapist, childbirth educator and director of Hypnobirthing Australia, says that when you experience fear during labour, the fight or flight response is activated. Blood is then directed towards your arms and legs to help you fight the perceived threat, and away from the non-essential parts of the body – including the uterus, which becomes starved of pain-protecting oxygen. As a result, you feel more pain.
"This is a response that humans have had since the beginning of time," says Spilsted. "Originally it was to help us get away from genuine threats, but nowadays we can experience the same response during labour just by arriving at a hospital, or our caregivers mentioning something being out of the ordinary."
Because of this, easing your fears can help boost your pain tolerance during labour. According to Dr Robinson, using a breathing rhythm you've practised prior to labour is one of the most effective ways to break what experts often call the 'fear-tension-pain' cycle.
"It's about learning how to bring yourself out of that [fearful] state in order to be able to focus on the moment and where you are at the time, which inevitably increases your coping," she says. "Breathing slowly and calmly – four seconds in, four seconds out – is teaching the body that you don't need to be frightened. It brings everything back into your control."
As such, birthing methods that teach relaxation and meditation techniques, such as hypnobirthing and Calmbirth, are becoming increasingly popular. Spilsted says hypnobirthing helped her give birth to three children without pain relief – even though she famously fainted after skinning her knees during a night out with her husband.
"I don't have high pain threshold at all!" she says. "But I utilised breathing, visualisation, relaxation and self-hypnosis for all three of my births. They were all natural and I honestly don't believe that what I experienced during my births was anywhere near the intensity that other women traditionally experience.
"At first I thought that I was just a superwoman and great birther. Then I used myself as a guinea pig during my third labour and stopped using the techniques for a few minutes – it killed! No wonder women are calling out for epidurals."
Mother-of-two Elle Black suggests that all pregnant women learn meditation techniques before giving birth. "I tried to educate myself as much as possible about things I could do to make the pain less and also make the experience quicker," she says. "Breathing and meditation help you to focus and get through difficult periods.
"With the birth of my first child, I was meditating a lot before he was born, and found it really easy to focus on my breathing during labour. It was a very easy birth. I did a lot of standing, rocking and walking around during contractions, and after we arrived at hospital it was only about one and a half hours later that he popped out."
It's also important to note that your labouring environment affects your pain threshold –this can include noise, light, temperature, space for movement and placement of hospital equipment. Many women have experienced labour stopping after they entered the unfamiliar surroundings and crowded wards of a hospital. Research has even found that using a screen to hide emergency equipment in delivery rooms can shorten labour by up to two hours.
So there's a lot to be said for customising your birthing room as much as possible: ask ahead of time if you can turn down the lights, play calming music and move the furniture around. Create a private space with as much room to move as possible.
And, of course, don't forget to breathe.