Your hospital bag is ready to go. You’ve prepped the nursery, a name is picked out, and the freezer is stocked with quick postpartum meals. You’re ready.

And then it hits you… “OMG I am having a baby, and it has to come out of me.”

Don’t worry—almost every pregnant woman has this moment (including this midwife). You look down at your beautiful belly, full of baby, and think, “What are these contractions actually going to be like?”

Let’s talk about it.

First things first. Contractions happen in your uterus, the amazing muscle that houses your growing baby, and then help them to be born.

image 6049 Motherly

In the same way that your bicep contracts when you flex your muscles, your uterus contracts when you have a contraction. The main force of the contraction comes from the top of your uterus (called your fundus), but the entire uterus does the work of labor.

Contractions do two things:

  1. Dilate (open) your cervix to 10 centimeters (about the size of a bagel).
  2. Ease your baby down and out.

For more on how contractions do their work, and to see the difference between “real” and Braxton Hicks contractions, check this article.

Labor starts (we believe), by a combination of factors, one of which being your baby sending your body a signal that says, “I’m ready! Let’s do this!”

A hormone called progesterone works to make your cervix soft. (It’s also present in semen which is why people start telling you to have sex to get labor going when you go past your due date).

The other hormone is oxytocin, the love hormone. It’s the hormone you release when you fall in love, when you have an orgasm (again, why sex helps labor start) when you breastfeed your baby, and when you are in labor.

One of the awesome things about oxytocin is that it is also a pain receptor blocker. So, the very hormone that is causing those contractions is helping to relieve some of the pain caused by them—well played, Mother Nature, well played.

And speaking of pain (I know that’s why you’re here), let’s talk about it.

The primary, universal sensation caused by contractions is pressure—how women process that pressure is what varies.

Some women only experience pressure, but do not classify it as “pain.” I know popular culture would have us believe this is a myth, but it does happen—I’ve seen it! There are even women who have orgasmic births, where they orgasm as they are in labor and giving birth (oxytocin for the win!).

Many women do experience that pressure as pain of varying degrees, though. By the time you are full-term, your uterus is quite large (think watermelon). It goes all the way up to your diaphragm (just under your lungs), and all the way down to your lower back, groin and vagina. When all that contracts, we feel it—in our bellies, back (especially lower back), vagina, bottom and even in our upper legs.

Contractions usually start off feeling like mild period cramps, and then intensify in strength, frequency and length. (To learn more about how to tell when labor has started, read this.)

The extent of pain felt depends on so many things (probably many that we don’t know about yet)—the position of the baby in the uterus, the woman’s anatomy, her threshold for pain, fear and how the labor is progressing in general.

Now, I know you’re nervous. I was too, mama, believe me (I did it three times). But I’ve attended hundreds of births now and I want to share with you a few things to keep in mind (take a deep breath and imagine me reaching out and holding your hand right now ☺️).

1. This pain is normal.

We are not supposed to break our bones, or have our appendix rupture. When those things happen, we experience pain to let our brains know that something is wrong. We are supposed to have babies (if we choose to, of course). There is something very comforting about knowing that the pain of birth is normal* and natural.

*There are cases when pain lets us know that something else is going on—make sure to communicate openly with your health care team, so they can help figure out what’s normal, and what’s not.

2. This pain will end.

When you are in the throws of labor, it can be next to impossible to believe it will ever end. But I promise you, it will. And when it ends, you get a baby (the cutest one on this planet, if we may add).

3. Your birth. Your birth. Your birth.

Repeated because it’s that important. You have no one to answer to but yourself. You craft the labor experience that is right for you. Can I tell you a quick story?

When I had my first baby, I was already a midwife. Somewhere in my subconscious, I had apparently convinced myself that midwives have unmedicated births. And so I tried. For 23 hours. And I got stuck. I transferred from the birth center to labor and delivery, got an epidural, and later that morning I welcomed my beautiful daughter into my arms (I got to pull her out!).

I need an epidural. I am terrible with pain, and I was scared. But I tried to forced myself to have a birth that I thought I should have because… who knows.

And so, please, to thine own self be true.

If that means you know you want to have an unmedicated home birth, find a midwife and go for it.

If that means you know you want to have an unmedicated hospital birth, find a practice that will support you, and hire a doula.

If that means you know you need an epidural, get an epidural.

(And if you don’t know right now, that’s totally cool too.)

Talk to your provider, ask plenty of questions, and trust yourself.

Oh, and one more thing—

I highly recommend you take our online birth class. You can take it completely at your own pace, and fast forward to the parts that matter most to you (if you are very close to giving birth.

You’ve got this, mama. Promise.