For some, natural pain relief may not be sufficient to enable them to deal with the increasing intensity of contractions, and they may choose to use medication in combination with natural techniques. In some situations, for example if labor is induced (see Breech Baby) or augmented (see How Labor Progresses), contractions may start strongly rather than build up gradually and a stronger type of pain relief may be needed.
There are several types of medical pain relief available, which fall into two groups. Analgesic drugs dull the perception of pain, while anesthesia, which may be regional or general, numbs pain totally. In regional anesthesia, also known as a nerve block, local anesthetic drugs are injected around nerves that supply a particular area. There are several types of regional nerve block: epidurals and spinal blocks numb sensation in the abdomen and are used to reduce the pain of contractions; a pudendal block numbs sensation in the vagina and perineum and may be used in a forceps delivery. Occasionally, a general anesthetic is given during a cesarean.
Since all labors are different, it's not possible to have a "one size fits all" approach to pain relief. Being flexible and informed will help you feel in control. Read any literature from your doctor, go to prenatal classes, and ask questions. Try to eliminate any worries by increasing your knowledge, for example by asking if it's possible to attend a childbirth education class at the hospital that discusses the pros and cons of each type of pain relief. Keep in mind that some childbirth classes, like Lamaze and the Bradley method, can teach you breathing and relaxation techniques that may help reduce your need for pain medication during labor.
Having a birth plan ahead of time that outlines the circumstances during which you would resort to using medication for pain relief may be helpful for some women. For example, you may want to try to remain medication-free unless the pain is so intense, it interferes with your ability to hold a normal conversation, or it doubles you over in pain. Perhaps you'll seek relief if your labor drags on hours longer than you expected and you need some respite to sleep for a while to regain your strength for the upcoming pushing that you'll be doing. Whatever the case, you may feel more in control if you know ahead of time what your limits are and when you want to say yes to pain medication, rather than being overwhelmed by the situation, if you don't give it much thought beforehand.
Up until 150 years ago, there were few options for pain relief during childbirth.
The history of modern obstetric pain relief began in the mid-19th century with the discovery of chloroform. Nitrous oxide and opioids followed and at the start of the 20th century, enthusiasm for pain-relieving drugs was so great that they were overused, with women in labor in a state of near-unconsciousness. The natural childbirth movement in the 1960s and 1970s was a reaction to such overuse of drugs. In the 1970s another revolution was at hand as epidurals became available.
Whether you're still at home and it's too early in labor to get pain medication, or you're trying to wait it out at the hospital to see if you really need drugs, you can try any or all of the following techniques that may help to relieve pain without medication:
When you start to experience the pain of labor contractions at home, no matter how tempting it may be, do not reach for an aspirin to relieve your pain. Aspirin can be extremely dangerous during pregnancy, particularly in the third trimester and leading up to labor and delivery. The drug interferes with your blood-clotting ability, which means that your risk of a hemorrhage during delivery increases if you take aspirin in the weeks leading up to your baby's birth. Taking too much aspirin in the last trimester may actually prolong labor. Bleeding problems may even develop in your newborn. Taking aspirin regularly toward the end of your pregnancy can also affect your baby's heart or blood flow, so it's best to avoid aspirin, unless your doctor recommends you take it. Your best bet for dealing with labor pain at home is to keep active until it's time to head to the hospital. While you wait, do something to distract yourself from the pain, whether it's counting the length of time between contractions, packing your bag for the hospital or anything else that feels right. Ask your partner for a massage or try a warm shower. No matter what you do, refrain from drug use. This way, if you need pain relief when you get to the hospital-many women do-you won't have any medication in your system.
Excerpted from Pregnancy Day by Day.
Copyright © 2008 Dorling Kindersley Limited.
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