If you ask women who have been through labour how the pain feels like, majority will tell you that it is the most excruciating and indescribable pain ever. Some would liken it to having the most severe menstrual cramps… multiplied by 10! Most women will be able to tolerate the pain without any medical intervention; it depends on the threshold for pain and prior mindset and experience.
The good news is that labour does not have to be painful. It can in fact, be painless or at least, less painful. Women should not shy away from asking the doctor or midwife for the options available (and applicable) to them.
Let’s discuss some of the methods of pain relief in labour…
*EPIDURAL. This is the most effective method of pain relief. A tiny catheter is inserted into the space between the backbone and the spinal cord, and then an anesthetic drug is injected. Epidural blocks the pain almost 100 percent. It can also be connected to a device which is controlled by the woman herself (PCA: patient-controlled analgesia), such that she only administers it to herself when she feels severe pain. This form of analgesia can be combined with spinal anesthesia and easily topped up in case an emergency cesarean section needs to be done. It is also beneficial for hypertensive women as it decreases blood pressure. The major downside of epidural is that it increases the duration of labour because the woman would not feel the urge to push effectively. She will have to rely on the midwife to tell her when to push. Epidural also increases the incidence of assisted (instrumental) vaginal delivery and perineal injuries.
*ENTONOX. A combination of nitrous oxide and oxygen given by face mask during labour is also very effective in relieving the pain. It may cause drowsiness, nausea or vomiting.
*TRANSCUTANEOUS ELECTRIC NERVE STIMULATION. (TENS) As the name implies, TENS is a device that stimulates the nerves responsible for the perception of pain. It can be used to mask the effect of the uterine contractions during labour.
*ANALGESIC INJECTIONS. Examples are pethidine, pantazocine. These are related to morphine and they create a feeling of euphoria or “high”, in addition to pain relief. The main side effect is respiratory depression in the newborn but the effect can easily be reversed with an antidote (naloxone) given to the baby after birth. Weaker analgesics (like paracetamol) can be used in early labour but they tend to have little or no effect. NSAIDS are avoided because of side effects on the newborn.
*WATER BIRTH. Yeah, water is a powerful painkiller too. You read that right! Many hospitals in developed countries now have the option of delivering the baby inside a birth pool. This can also be achieved at home in selected low-risk pregnant women. Floating in the warmth of a pool of water helps to relieve the pain and pressure associated with labour.
*HERBAL PRODUCTS. I am not an herbalist, but I know there are several mixtures and concoctions that have been used and proven to be effective; though most have not gone through scientific trials. Care should be taken in using these products as they may contain substances that may be harmful to the baby, and there is a high risk of aspiration in case the woman vomits.
*RELAXATION TECHNIQUES. Non-medical methods of pain relief remain more popular and preferred by most women; mainly because of the fear of side effects of medications. Relaxation can be achieved through deep breathing exercises, massage, aromatherapy, acupuncture and of course, moral support from husbands or other close relatives.