Whether you are giving birth for the first or the fifth time the question of pain management during labour will arise.
Jacky Bloemraad-de Boer discusses several natural options for you to consider.
As an expectant mother approaching your due date, you may start wondering/worrying about the pain that you will experience during labour.
Expectations regarding labour pain tend to be coloured by the past experience of your friends and family and sometimes by your own. However, the intensity of labour pain, the length of labour and each individual woman's response to the pain varies widely. Also the environment in which you give birth and the support you receive from your caregivers and companions will affect your reaction to pain and your ability to cope.
PAIN MANAGEMENT
It is important to orientate yourself as to what pain management is available in the setting in which you plan to give birth. One thing is certain, the more you know about the process of giving birth and your options for managing the pain, the better your experience will be. In fact, education itself is a form of pain relief. It takes away the fear of childbirth and in doing so can minimise the pain when the time comes.
Options
Each pain management option has pros and cons.
- Relaxation, acupressure, acupuncture, massage and breathing techniques can help you to cope better with the pain but they won't take the actual pain away.
- Medication can make contractions less painful or even painless but any pain medication has side effects.
ADVANTAGES OF NATURAL CHILDBIRTH
If you want to be an active participant throughout labour and have minimal routine interventions in the birth process then a natural, non-medicated approach to controlling labour pain will suit you best. Choosing this route is accepting that there will be some pain and discomfort as part and parcel of giving birth but with the right preparation and support how you experience this pain can vary enormously and the experience could leave you feeling empowered and deeply satisfied by natural childbirth.
The pros for natural childbirth
- Natural childbirth techniques are not invasive, so there's little potential of harm or side effects for you or your baby.
- Many women have a strong sense of empowerment during labour and a feeling of accomplishment afterward. Despite having had to endure pain many women report that they would opt for natural childbirth a second time round.
- There's no loss of sensation or alertness. You'll be awake and active during labour and birth which will make you more able to feel what you need and you will be able to move freely, facilitating your baby’s journey throughout the process.
- Your partner will feel more involved as you work together to manage your pain.
- You won’t need to be hooked up to an IV or monitoring machines so it's easier to move about, walk, take a shower or a bath and to use the toilet (instead of a bedpan).
- You're less likely (than women who get epidurals) to need chemical Oxytocin (Pitocin) as stimulation, a vacuum extraction or forceps delivery or bladder catheterisation.
- You are more alert when your baby is born so you can experience the first precious moments with your baby. It is the best start for your baby.
NATURAL PAIN MANAGEMENT DURING LABOUR
Acupuncture and Shiatsu
Women who receive acupuncture during labour experience less pain and require less analgesic medication.1
In many countries midwives are trained to give acupuncture during childbirth, if this is not the case in your situation, find an acupuncturist that specialises in acupuncture during child- birth. If you don't like the idea of needles many acupuncturists will use acupressure during birth.
Reflexology
During labour, applying pressure or strokes to specific points on your feet is said to stimulate the pituitary gland to release hormones that benefit labour and reduce pain. As in any form of massage, reflexology encourages the body to release endorphins. Endorphins are natural pain killers and are needed in high quantities during childbirth.
Massage
Massage can help you to focus on your breathing exercises during a contraction. Lower-back massage during a contraction can be a wonderful way to relieve pain as it works by releasing pain-killing endorphins. A foot massage can relax you and ‘pull’ the energy out of your head and downward.
Some women find that they don't want to be touched while others have a specific need for soft or hard massage during labour so although you could practise before labour, the comfortable massage pressure will be determined by you during labour.
Hypnosis
Hypnosis is a focused state of concentration that allows you to relax your body, guide your thoughts and control your breathing. Hypnosis doesn't stop the pain of contractions. It is simply a state of mind that may help you ride the wave of each contraction and trust in your body's ability to give birth. Self-hypnosis will aid you to let go of the fear of pain. There is a specialised childbirth self-hypnosis technique called HypnoBirthing where you learn self-hypnosis techniques. HypnoBirthing can help you to trust yourself and your body thereby allowing it to do what it is naturally able to do.
Breathing techniques
You can learn breathing techniques during pregnancy that you can use during labour. Good breathing techniques help lessen the pain due to the fact that your body relaxes.
Bradley Method
This method, developed by American obstetrician Robert Bradley in the late 1940s, embraces the idea that childbirth is a natural process and that, with the right preparation, most women can avoid pain medication and routine interventions during labour and birth. Proponents claim that nearly 90% of women who deliver vaginally using the Bradley Method do so without drugs. The programme lasts 12 weeks, and is more intensive than other childbirth education classes. The Bradley philosophy says that it takes months to mentally, physically, and emotionally prepare for childbirth and parenting. It prides itself on addressing all aspects of natural childbirth, as well as many pregnancy and post- partum issues.
Lamaze
The primary goal of Lamaze is to increase a woman's confidence in her ability to give birth through education and support. Today’s Lamaze encourages women to trust birth, to actively work with their labours, and to choose caregivers and places of birth that promote, protect and support natural birth.
Warmth and water
Some women find warm water in a bath or shower – or even a sponge or footbath helps provide comfort and relief. Birthing pools, which you can rent for homebirths and which are available in many hospitals, are known to provide substantial pain relief. A hot-pack, hot water bottle or simply warm towels on the lower back and sometimes on the lower belly provide good pain relief.
Obstetric pulsar: TENS
A Transcutaneous Electrical Nerve Stimulation (TENS) obstetric pulsar machine works by ‘disturbing’ pain messages from your body to your brain thereby reducing the pain. TENS also stimulates the release of endorphins – your body's' own natural pain-relieving hormones. The pain relief is administered by four electrode pads, which are placed on your lower back and are connected to the TENS machine. A TENS is most helpful in the earlier stages of labour. TENS machines can be hired or purchased.
Comra laser therapy works well for pain management in labour and is used in midwifery for the preparation of nipples and perineum and the healing of these areas after birth. It is particularly useful for healing the perineum – on day three the perineum looks like it would normally on day ten.
Mobility
Sometimes simply being mobile will help you to cope with the pain. It will aid the baby's passage down the birth canal possibly making the birth shorter. Most women whose births I have attended are shocked to find what a positive difference it makes to be OFF their backs during contractions.
CONCLUSION
Working with your body during natural childbirth with the aid and support of natural pain management can be a deeply rewarding and memorable experience. You are fully connected to the process and the final glorious outcome – your precious baby.
Editor's note: We recommend reading this article Keys to a Healthy Pregnancy and Exercise in Pregnancy – Before, During and After.
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