What about the pain of labour and birth?

some thoughts from Sylvie Donna

WHAT, NO PAIN RELIEF? Doing without pain relief of any kind may seem a crazy idea. After all, didn’t Queen Victoria start us all on the path to freedom when she first used choloroform in 1853? Hasn’t modern medicine made the agonies of childbirth a thing of our primaeval past? Unfortunately, it hasn’t.

POST-BIRTH PAIN... Have you ever considered what comes afterwards? Instead of the pain of contractions and the birth itself, many women nowadays experience a whole host of postnatal problems. Believe it or not, these can be a direct consequence of using pain relief during labour! What?! Why?! How?!

Firstly, stitches are fairly common after using pain relief. Women are simply more likely to tear “down there” when they have less sensation because they can’t feel what’s going on.

Postnatal depression or simply a feeling of anti-climax are extremely common because any kind of pain relief can stop women from experiencing the natural endorphin high of a natural birth.

Babies often have problems with breastfeeding when their mums have used analgesia during the birth. This may be because of a weak suck (because of the drugs still in his system) or simply because he’s too groggy in the all-important first hour of life to tune into his instinctual knowledge of how to feed.

Incontinence resulting from a forced or a forceps birth can persist not only for weeks, but months or years after the birth.

Some research suggests that babies who’ve had drugs in their system at birth are more likely to become regular users of recreational drugs when they’re teenagers. Several little-known research studies have established a clear connection.

So while women who’ve had natural births usually have an easy time afterwards, women who’ve escaped the worst of the pains of labour and birth often have to face the music afterwards.

EPIDURALS... Aren’t they the ideal form of relief? Even though they sometimes provide a couple of hours of relief, even epidurals give some women more than they bargained for…

Sometimes, they don’t take effect properly and the resulting lop-sided pain is apparently harder to bear.

Often they slow down a woman’s labour because she usually moves around less, or not at all, and her blood pressure goes down.

Sometimes they’re so ‘effective’ they interfere with a woman’s ability to push her baby out.

They make a forceps birth or a caesarean much more likely. • They sometimes cause headaches or backache for weeks after the birth.

They sometimes leave women with a feeling of disempowerment. It’s difficult to feel empowered (or even dignified) when attached to a blood pressure sock, a drip and possibly even a catheter to drain off urine.

So longer-term psychological and physical pain may be the price to pay for a couple of hours’ relief.

Surprising reactions to pain - Some women, like Libby Fogg, have discovered quite by accident that experiencing the pain of labour and birth can actually feel pretty good! After a fairly high-tech first birth, Libby’s second labour went much faster than expected. “I went from stage one to stage two in about five minutes. From being able to hold a normal phone conversation one minute, I was suddenly only capable of screaming blue murder the next,” she explains. And she found the pain different in this second labour: “There was a strange pleasure in riding the pain wave knowing that my body was not some alien passive thing, a useless lump of flesh, but an active wonderful powerful thing that knew what it was about, and was doing this job all by itself. Now I know why people get so evangelical about natural childbirth. It was a wonderful experience, and I am grateful for it.”

REASONS TO MAKE A POSITIVE CHOICE

The wish for a better experience this time round... Some women actually choose in advance to give birth without pain relief. Very often this isn’t just because of what they’ve read, it’s actually because they’ve tried the ‘medicalised’ route, with so-called ‘pain relief’ and have decided they want to go for something different. Pauline Farrance, says, “The birth of our first son in hospital two years before affected myself and my family so much that we were determined our next baby’s introduction to our world would be a happier and easier event.” Her partner describes their second child’s birth as “a trouble-free and memorable event”. He says, “it gave us so much joy and confidence during the weeks that followed” and Pauline herself described the birth as a magical experience which she so much wished she could have repeated! This, despite the fact that she used absolutely no pain relief.

A mind which is open to what life has to offer... Nina Klose, whose first baby was eventually born by caesarean, feels “There is nothing ethereal about pushing a baby into the world” but she nevertheless says it was a real peak experience for her. “Now that I've tried it both ways, in my opinion natural birth beats medical birth, hands-down.”

A smoother labour... Her view is echoed in numerous books on natural birth. Perhaps this is because labours really do seem to go more smoothly when there are no drugs or interventions involved. It makes sense when we consider that any drugs put into our system are bound to disturb the delicate balance of things going on during labour and birth, and even afterwards in the delicate postnatal period. One way in which drugs have an effect is that they can slow down contractions. This may be because of the changing chemistry within the woman’s body, or it might be because drugs make birthing women less inclined to move around, or less able to. Weaker, less frequent contractions are bad news from the point of view of having a smooth, easy and safe birth because they don’t do much to help the cervix open or push out the baby! As we’ve already seen, drugs also have the effect of making women less sensitive to their bodies, simply because they cut out sensations. These sensations, which many (but not all!) women experience as pain, make most women move around into more comfortable positions which are also better for getting the baby born safely. When women are completely undrugged and undisturbed by methods of pain relief, their minds and bodies may well be able to work in perfect synchrony. Women who have really experienced a completely natural birth say they feel as if they went into a completely different state of mind. Dr Michel Odent, a childbirth educator who’s perhaps best-known for his work encouraging women to use warm water instead of other forms of pain relief, describes this as ‘going to another planet’. In this interesting state of mind, women appear to tap into the right side of their brain and their instinctual knowledge of how to give birth.

NOT THE 'TYPE'? You may find yourself wondering whether you’re really the type to give birth without any form of pain relief… If so, it might reassure you to hear that among women who choose to do things naturally there aren’t many flower-power, hippy-dippy, dope-smoking types around these days. Natural birthers are more likely to be financial editors, teachers, builders or even engineers. I’ve done it three times myself and I’m an in-company English and cross-cultural trainer. Given the advantages for both you and your baby, you may just find you are ‘the type’ after all.

Why not give it a go?! Take your labour and birth just one minute at a time. You might thank youself for it later.

To find out more and to find ways of improving your own experience, try one of these books…

If you want to think about the pain in more detail – Birth Pain: Power to Transform.

If you’re thinking of helping yourself cope by giving birth in a midwifery-led birthing unit or at home – Birth Pain: Power to Transform.

If you had a caesarean last time and don’t know if you can face a whole labour and a vaginal birth next time – Birthing Normally After a Caesarean or Two.

If you’re worried about how your baby will be dealt with directly after the birth and want to minimise any unnecessary distress – Welcoming Baby.

If you just want a little inspirational, reassuring reading about other women’s experiences – Surprising, Inspiring Birth.

If you want more information so you can make better informed choices – Birth: Countdown to Optimal.