The pain is more from the contractions than anything else. When giving birth, you'll be so focused on the contraction pains that you can't even think about anything else. When the baby is ready to come out, you will naturally have the urge to push...a bit like passing motion. Your gynae will probably inject the area to numb it before making the episiotomy snip and sewing it up. You won't feel the pain from the wound except the pull of the thread when he/she is stitching you up. You only feel the soreness later when everything is done.
If you can't tahan the contraction pains, there's always pain relief options like laughing gas, pithidine jab and epidural. But do note that there are pros and cons of each and it differs from person to person.
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