It’s the “mother of all menstrual cramps.” It’s a wave, and you have to “ride it.” It’s not actually painful, but “intense.” It takes over your “whole body.” It hurts in your back. There’s an “elephant sitting on your pelvis.” It “kills.” It’s a very “bad, strong charley horse in the abdomen.”
In some ways these descriptions are all true, but put together, these images and metaphors can be confusing. Maybe that’s because women experience (and describe) contractions so differently. But given the variation in experience and semantics, there is still the fact that a contraction is a particular bodily function. Since the question, “But what does it really feel like?” is asked to me so often in childbirth class, I’ve come up with a few ways to describe it.
Here’s my best shot:
The uterus is the biggest muscle in a pregnant woman’s body. When it contracts it is tightening. You don’t contract it yourself; it happens involuntarily, in a vaguely similar fashion to the way the stomach contracts involuntarily when you vomit. There is a squeezing and tightening and shrinking of the muscle. Basically, the uterus is tightening and getting smaller. The shrinking pulls the cervix open and eventually pushes the baby into the birth canal (vagina) and out of mom into the world. So you can imagine that the sensation of a contraction is a stretching, muscular pain.
Now think about where you uterus is. Yes, it’s in your pelvis, but it’s also up by your ribs and connected to the muscles in your lower back by ligaments. It’s basically dominating your entire torso. So for the long part of labor before you are actually pushing the baby out, the sensation of a contraction is felt up around your waist, maybe your lower back (this is especially true if your baby is posterior and causing what’s called “back labor”) and in your pelvic area.
Remember that contractions come and go; the cramp analogy only works if you imagine the cramps being turned on and off at intervals. Menstrual cramps are really more of a consistent dull ache that is more or less dreadful. A labor contraction can be very cramp-y — some women strongly associate them with menstrual cramps, others less so — but unlike cramps the pain is pronounced and then stops. Amazingly, most women have virtually no pain between contractions. Some women who have “back labor” may continue to feel pressure on the back between contractions, but most women feel little to nothing. In fact, even at the most active, difficult part of the dilating phase, known as “transition,” when contractions are so close together and last up to 90 seconds, the breaks can be pain-free. Mom can actually fall asleep for two minutes between them if she’s really worn out. But the fact that contractions come and go really makes it hard to find the perfect analogy for labor. I suppose the experience of vomiting comes and goes, but even that is different as there’s almost continuous feeling of nausea between the bouts of being sick.
The breaks are long in early labor (between 5-30 minutes!) and then get shorter. For very active labor, the contractions come about every 2-3 minutes, so even though there are breaks, it can feel more or less overwhelming. It’s also a passive situation unlike the pushing stage when you’re more involved. The contractions are like waves in the sense that you’ve finished one, and it’s only a matter of time before another comes at you. They also swell: they start out relatively easy, then get harder and harder until they peak and the intensity goes down again. When you look at contractions being measured on a monitor, you can see the line swell up into to a high point and then slowly dip down. So what is that like? Well, when a hard one is coming on, you’re thinking about how to deal with it, then when it’s going down, you feel a sense of relief. All of labor moves through this pattern: here comes another one … there it goes.
Since your torso is a pretty substantial part of your body, it can feel like you’re being taken over by the contractions. A menstrual cramp might make you grab your lower abdomen, but with a contraction you can feel like it’s sort of spreading from your lower back around your torso to the extent that it feels quite consuming when they are longer and stronger.
So the bottom line: it’s muscle work, it’s tightening, it’s cramp-y, but it comes and goes and can be felt all over and around your torso and pelvis. In addition to the option of pain medication, immersing yourself in warm water, taking a shower, using heat pads, getting massaged on the lower back, and moving into positions that help open the pelvis and pull the baby (pressure) off the lower back are all ways to cope with contractions.