Whether pushing or contractions hurt more depends on the individual, but most birthing people say contractions, especially during transition, hurt more than pushing, though pushing has its own intense pain. Contractions in early labor feel like strong menstrual cramps or backache, but in active labor and transition when cervix goes from 7 to 10 centimeters, contractions become very long, strong, and close together with almost no break, causing overwhelming, wave-like pain in abdomen, back, and thighs, often accompanied by nausea, shaking, and feeling out of control. Many describe this phase as the most painful because you cannot do much to relieve it and you are exhausted. Pushing, while still painful, often feels more productive and purposeful, as you have something to do with the pain. Pushing brings pressure, stretching, and burning in vagina and rectum, particularly during crowning, which is sharp and intense, but many find pushing less suffering than contractions because it gives a sense of progress and often provides some relief between pushes. With an epidural, both are less painful. Overall, most report transition contractions as worst, with pushing burning as second worst but more manageable mentally.
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