Okay then, here we go.
If you're asking for MY view, this is only my opinion and not be taken offensively by anyone as everyone's labour experiences are different. MY view is that pain relief in labour is not necessary.
However I do agree very much with educating yourself before the fact. Then when labour does come you are much more aware and able to make informed choices that are best for both you and you baby. Being well informed can also lessen the fear of the unknown, and therefore in itself make labour faster and smoother. The more relaxed you are, in general, the more your body can do it's stuff.
Your body is built to birth babies, and left to it's own devices will do just that. I can only speak for my own experiences, but in the run up to labour I was sure I wouldn't need pain relief, although I had researched all the options fully. I had a home birth and sure enough, never felt that pain relief was needed. Every woman is different. I truly believe that although the most important thing is a healthy mother and baby, the second most important thing is that the mother is happy and empowered by her birth experience. Whether that be an elective c-section, an epidural at the first twinge, gas and air at a hospital, or a natural home water birth. Whatever that woman wants, it's her experience, her body, her baby, and she should be happy with it. And long as she has made informed decisions she is comfortable with every step of the way and not had things pressured on her or done to her by her care providers that she never wanted.
There is a growing argument and movement againt the active management of labour, or the obstetric model of care, which includes avoiding things like hormone drips, artificial rupture of membranes, epidural anaethesia and episiotomy unless they can be proven to be medically necessary. The reason is that most of the procedures above cause so many knock on effects and problems with the flow and natural process of labour that they lead to what is known as the spiral of interventions. Which means that once you have one, you end up with the next, and the next, and the next.
For example, a woman's labour is induced for a non medical reason. They give her prostaglandin pessaries to soften her unripe cervix. Once contractions start, which can take days, they'll put her on a hormone drip, usually oxytocin or pitocin in the US. This artifically hyperstimulates the uterus, causing unnaturally aggressive contractions that are painful for the mother and sometimes distressing for the baby, who is yet to move into the optimum position for birth. Due to the hormone drip and IV, the mother cannot move around as her care providers have a foetal monitor continuously monitoring her baby's heart rate. She cannot get comfortable, the contractions are strong, she isn't allowed to move. She starts to consider pain relief and is usually given gas and air or administered an opiate drug through her IV line. These drugs are always administered with an anti-emetic which attempts to stop you vomiting, but this is not always successful. These types of drugs are proven to be transmitted to the baby and can make it sleepy, or cause heart decelerations. The baby cannot descend against gravity as the mother is strapped to the bed, and cannot move into the optimum position for birth. The baby cannot pressure the mother's cervix so progress is slow. To fix this, the care providers turn up the drip to increase the contractions and when the cervix begins to open, they will artificially break the waters with a long hook. This starts the clock, many carers will have a set amount of time you are 'allowed' to labour after rupture of membranes, and if you exceed this they will take other measures for example a Caesarian Section. The effect on the baby is like that on your rubber duck when you pull the plug in the bath. It is sucked downwards and whichever bit of it's body plugs the hole first will be the presenting part, again the baby has had no opportunity to get into the optimum position for birth and now it's head is descended, it would be difficult for it to turn. This can result in back labour for the mother, which makes her go for more pain relief, so an epidural is administered with a needle in her spine that she has to endure and sit still throughout her contractions; or risk epidural headache or even paralysis. The epidural is administered. Over 15% of women experience no or partial pain relief with an epidural, so it is not a magical cure all. The woman is now numb from the waist down, unable to feel her baby, unable to feel the urge to push, usually catheterised instead of being able to use the toilet. It then becomes an unnatural waiting game. Vaginal examinations are performed regularly which increase the risk of infection to the baby. An electrode is screwed to the baby's scalp with wire to monitor it's heart rate more closely. This uncomplicated pregnancy is now a high-risk labour and birth - any induction or epidural birth is high risk, requiring constant monitoring. If the baby is too distressed by the artificially strong contractions bashing it's head againt the mother's unripe cervix that the mother can't feel, the mother will be rushed for a Caesarean Section.This is easier to do with an epidural already in place. If your baby tolerates it, then it's the magical time, your care provider says you can push, so you push. You're on a clock. Most places will again have a length of time you're allowed to push for before they intervene. Without the natural urge to push, it's a skill you have to learn, and as you can't feel it, you have to rely on someone else to tell you how effective it is. This all takes time, reducing the amount of time you have to get your baby out. The baby's heart rate drops. This is fairly common during pushing but foetal heart traces highlight this occurance and make it impossible for the doctors not to act on this. You may be prepped for c-section or taken to the operating theatre to attempt ventouse or forceps delivery. Or both. The scissors are brought out and an episiotomy cut into your perineum . On insertion of the forceps, this turns into a third or fourth degree tear. The instrumental delivery fails. Your baby's heart rate has plummeted due to the stress of being yanked about by the head. It is at a terrible angle. Your epidural becomes a spinal, they slice though your abdomen and womb and within minutes your baby is out. It's head is misshapen due to the ventouse and bruised from the forceps. It requires suctioning to breathe due to it's chest not being squeezed through the birth canal. It needs oxygen due to being stuck in the wrong birth position for so long. Eventually you'll get to see it whilst you are being stitched up inside and out. When you get to the recovery room you may be able to hold it. For the next few days you'll be on strong painkillers which can effect breastfeeding, immobilised for hours afterwards due to the epidural and spinal. Unable to move for days afterwards due to the pain and soreness, unable to care for your baby, and hospitalised for the first week of your baby's life at least. Physical recovery from a situation like this can take months, and emotional recovery can take even longer. The physical and mental scars from this birth will affect future pregnancies and births. Yes, you have a healthy mother and baby. But is that really the only consideration here??
This is an example of how your need for pain relief is entirely dependant on the labour situation you find yourself in. If your labour is allowed to progress normally as nature intended, you will usually have an easier and shorter labour with less need for interventions. If the above story sounds outrageous, it is exactly what happened to a friend of mine on the 1st March, when she was induced at 39 weeks due to the doctors telling her she had a large baby. Her daughter was born weighing 6lb 15oz. The moral of the story is, if you avoid unnecessary interventions, your need for pain relief should also lessen.
There are many ways to relieve the pain of labour that work naturally with the body and help rather than hinder the process. Breathing tehniques sound trivial but many women equate their effectiveness with that of gas and air - the main benefit being to take their focus away from the pain and into their breathing. Of course breathing well also helps with relaxation which alleviates pain. The more relaxed your body and muscles are the less work the contractions have to do so the less intense they will feel.
Water is an incredible pain reliever. Just think of the effect of a hot bath on achy muscles or period cramps. It's nature's natural pain relief, many native tribeswomen traditionally give birth or labour in water and have done for centuries. Water also supports stretched muscles, making contractions more effective and tearing less likely.
Massage and counterpressure are a great help in labour, many midwives are trained in massage which can also be used with aromatherapy to create a relaxing atmosphere and help your labour along.
A lot of women swear by alternative pain relievers such as homeopathy, aromatherapy, hypnotherapy and acupuncture. I have not personally tried these so I cannot comment on their effectiveness, but if it interests you there is a lot of information out there.
The best way to cope in labour is to get it over with! There are many techniques to speed up your labour safely and naturally, including positioning, keeping upright, walking around. There are props such as birthing balls, birth pools, birth stools, birth bars, every one desgined to help you into an effective position for birthing. Your midwife should help you with information about these options. Don't dismiss non medical options, at least be educated and keep an open mind, if you try it and it doesn't work for you, you can just stop. If you try pethidine or an epidural and it doesn't work for you, you're stuck with it!
I found my own labour and birth amazing. I gave birth at home to my first baby in November, one week overdue. I used positioning, a birth ball and breathing to cope with my labour. I found my bed the best place for early labour, then I was up and moving. I leant over the sofa arm, and the side of the bath, because I needed to be on all fours. I was walking up and down the stairs repeatedly an hour before she was born, helping her to descend naturally. I gave birth to her on her bedroom floor with less than a half hour of pushing. The midwife was here for the last twenty minutes and watched me as I birthed my baby. I caught her, I was the first one to hold her, the first one to touch her, and I was the one to announce her sex. She weighed 7lb 4.5oz and was perfect. I was up and about within ten minutes after delivering the placenta, after a cuddle and a feed I cleaned myself up in the bathroom, the midwife left and we were a family. I suffered no tears, needed no stitches, never had a vaginal examination, in fact I can't recall the midwife touching me in any way. That birth happened the way nature intended, it was hard work with a lot of luck thrown in.
I wish you all the luck in the world with your birth, whatever you choose. As long as you arm yourself with the facts and make informed decisions the chances are you'll come out happy with your birth experience, and ready to do it again some day! This is what matters, aside from the health of mother and baby, your right to choose and be happy with your choices, and to recieve the care that you require and the level of intervention you are comfortable with. If you want every pain relief going, please do not let anyone make you feel like a failure. Many women are brainwashed into this one. Have the birth that YOU want, as long as you are aware of all the facts, risks and benefits of each choice you make.
I wish you all the luck in the world! Thre are many links below for further reading. Congratulations!
2007-03-24 03:03:12
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answer #1
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answered by Up-side-down 4
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