It is no secret that labor can be a painful experience for many women. It is probably one of the better-known truths about birthing a child. While each woman will have a different experience with pain during labor (and it varies for each delivery!), most women agree that there is some degree of pain.

Several factors affect a woman’s perception of pain, including anxiety, fatigue, and fear. Studies have shown that a woman’s mindset about the labor and delivery process, or about pain in general, greatly affected their birthing experience. The truth is, pain is highly subjective. However, research implies that outside factors, such as your mindset, preconceived ideas, and environment play a significant role in the pain you feel during labor.

Whether you’re giving birth in a hospital, a birthing center, or at home, some things make labor pain worse. Here are 11 things you need to avoid if you can.

11 Things That Make Labor Pain Worse

1. Pitocin

The use of Pitocin to induce or speed up labor causes contractions that are longer, stronger, and closer together. Stronger, longer contractions = more pain! Plus, Pitocin doesn’t always speed up labor. It may make the labor experience longer and could lead to a cascade of other interventions (like a C-section).

2. Dehydration

Not drinking enough water can cause muscles to cramp and is more common in pregnancy. Dehydration may also trigger Braxton Hicks and may make already painful uterine contractions more severe.

3. Fearful Mindset

When you are fearful, your body tenses, your heart rate increases, your blood vessels constrict, and your breathing rate increases. This is the classic “fight or flight” response. Studies show that women with fear of childbirth experience significantly more pain than those who don’t share that fear.

4. Lying on Your Back

Lying on your back during labor puts a lot of pressure on your spine and can be the most painful position for labor. The supine position also forces you to work against gravity. Evidence suggests that laboring on your back may also increase the risk of fetal heart rate decelerations. The American College of Obstetrics & Gynecology no longer recommends a supine position as the “proscribed” laboring position.

5. Not Having Trained Support

According to studies, having a birth doula or support person trained in pain-relieving techniques is immensely helpful. They will be able to suggest natural pain-relieving methods and advise you on whether you should choose pharmaceutical relief. Having a doula or midwife who can guide you through the process may make your labor less painful than it needs to be.

6. Stressful Environment

If your labor environment is causing you stress, your body will react by tensing up, making the pain worse. Your labor environment may be a more determining factor of how much pain you experience than any other factor. Make sure your birth environment is as calm and soothing as it can be. Using a doula, listening to music, and practicing your breathing can help with this.

7. Not Learning Natural Pain Relief Options

Many natural pain relief options are safe and effective. Make sure you are familiar with each of them and include the ones you feel comfortable with within your birth plan.

8. Fetal Malposition

When your baby is positioned improperly in your uterus or birth canal, it can cause very intense pain, especially back labor pain. Make sure you have a plan to help your baby get and stay positioned correctly (the Rebozo Sifting Method is a preferred method among many practitioners).

9. Not Breathing Correctly

It can be hard to remember to breathe properly when you’re in the middle of a painful contraction. But learning effective breathing techniques for labor can help relax your body and relieve your pain.

10. Tight Muscles

Seeing a chiropractor and regular massage during pregnancy will prepare your body to be relaxed and ready once labor starts. Additionally, getting a massage or a chiropractic adjustment during labor can help get and keep your baby in a good position and reduce the chances of a breech baby or shoulder dystocia.

11. Not Listening to Music

Spend some time making a birth playlist! Studies have shown that women who listen to music during labor experienced less pain than those who don’t. So bring your iPhone and a Bluetooth speaker and pump up the volume!

At the end of the day, how a woman feels during her birthing experience and how much pain she experiences is a surprisingly complex relationship. More than likely, you will experience some degree of pain during your labor. However, there are things you can do and things you should avoid to make your birth experience as comfortable as possible. One of the most important things you can do is remember that you were created to do this, and you are fully capable of accomplishing it! You, mama, have got this!