Where to begin? This is probably the biggest discussion in an antenatal class along with the stages of labour. With the over medicalisation of birth since the 1950's the need for women to know how to use more natural methods of pain relief and become more in tune with their body is at an all time high.
At the moment I am creating an activity for my NCT classes for pain relief and so I thought I would share my thoughts and findings as a guide. Here are all your choices:
Oxytocin (the love hormone) is the mother of all hormones for labour and birth. It starts labour and it ends labour. It is the magical natural drug we need in order to birth our baby and the placenta and initiate feeding. Mix oxytocin with endorphins (our natural pain relief) and you can birth your baby. What's really clever is that endorphins will increase as your contractions increase so your body is able to deal with this uptake. What we don't want is adrenaline which produces our fight or flight response. There may be a small spike of adrenaline during the "bearing down" stage to give you a real surge of energy to birth your baby but we want to keep it at bay otherwise. No fear thank you!
2. Breathing and relaxation techniques/Hypnobirthing
Mind over matter! Research has shown that the use of hypnosis for labour leads to shorter first and second stages, less reported pain, less need for opioids, and less incidence of postnatal depression. No known cons! Focusing on something other than "pain" could be your saving grace. What happens when you dread something? It takes twice as long to happen. But what if you welcome your contraction/surge and count how many deep long breaths you can take while its happening? I promise you it will feel super quick.
I am obviously pro massage as a massage therapist. The list is endless but massage in labour has been found to reduce stress, encourages effective good oxygen filled breathing, lowers blood pressure, reduces anxiety levels, reduces pain, floods you with oxytocin when your partner or doula or someone you trust does it, stimulates your natural endorphins, relaxes your muscles so that your uterus relaxes too. It is also a wonderful way to bond and connect with your partner in pregnancy and then in labour as it brings you back to those wonderful moments of practice.
Be it a warm bath, a warm shower or a birthing pool of water filling your body with warmth on the outside can fill you with endorphins as it relaxes your muscles, creates a sense of feeling safe, homely, warm, protected, surrounded with love. A lot of women report that their body instinctively needed water during their labour and the minute they submerged all "pain" was gone from their body. 75% of your body weight is supported in a water birth pool. Amazing!
5. Entonox (gas and air)
A gas mixture of 50% nitrous oxide and 50% oxygen which you breathe in through a mouth piece.
Pros: You have control of the mask, doesn't affect the baby, it works quite quickly, the effects also wear off quite quickly, you can stay mobile and active, can be used at home.
Cons: Might make your mouth dry, you may feel sick, you may feel light-headed, may not be as effective as you hoped.
6. Tens machine
TENS is a drug-free kind of pain relief often used by women in early labour. TENS stands for Transcutaneous Electrical Nerve Stimulation. The machine sends small, safe pulses of electrical current via the leads to the pads on your skin. The pulses pass through your skin and into your muscles and tissues. This gives you a gentle tingling or buzzing sensation, which may be stronger or weaker, depending on the setting level.
Pros: You have control, you can remain mobile, doesn't affect baby, can be used in early labour, can be used with other pain relief, can help back ache, can remove easily if not affective.
Cons: Not everyone finds it helpful.
A morphine based drug which can help you to relax. It is given by injection into the muscle of the thigh by the midwife. Meptid is an alternative that can be used at home births or midwife led units. You will be given an anti-sickness drug at the same time, it takes 20 minutes to work, can last up to 4 hours and can have up to 2 doses in labour.
Pros: Can make you sleepy so you can rest if needed, can relax your womb, may take some of the pain away.
Cons: May make you feel sick or woozy, can not use water after using pethidine, may affect babies breathing when born, feeding may be difficult to establish, it is a sedative so may not work for reducing pain as it makes you sleepy.
The anaesthetist puts a hollow needle into the lower part of the back and uses it to place a very fine tube near the nerves of the spine. The needed is taken out and the tube remains in place to deliver pain relieving drugs throughout the rest of your labour.
Pros: Most women get very good or complete pain relief, it can reduce blood pressure for those with high blood pressure.
Cons: Takes time to set up and you have to sit very still, the pain relief effect may be patchy, 1 in 6-8 women may need the epidural repositioned, immobility means you may lose the "pushing" sensation, you need a drip to maintain blood pressure, you need monitoring every 15 minutes, your baby needs to be continually monitored, you will likely need a catheter, the chance of an instrumental delivery goes up from 7% to 14%, loss of active birth, and you may get a headache.
So there is the rundown of your options. So many others such as the home? Would you consider your home an effective pain relief option? Surrounded by all your lovely things, your smells, other children possibly, your bed! Nothing beats your home comforts when you want to be COMFORTABLE AND SAFE. So sit down, have a read, have a think. Know your options, learn about them, talk about it with your partner and go into birth fully informed and empowered with the knowledge to make those crucial decisions about pain relief whether natural or with opioids.
Antenatal teacher, hypnobirthing teacher, pregnancy and postnatal massage therapist, soon to be doula and breastfeeding counsellor.
A lover of all things birth related and the fight for birth rights.