The birth of a child is a unique and life-changing event for new parents, especially for mothers. No two pregnancies are the same. Similarly, labour pain is experienced differently by different women.
Some pregnant women may find their childbirth experience quite intense, with severe pain, while others may not.
There are various medications and non-medical choices available for mothers-to-be that help reduce pain during labour and childbirth.
Before we get into these interventions, here is some common advice from doctors for women to follow during pregnancy that will help them cope better with labour pain:
- Stay positive and do not let negative comments weigh you down.
- Be active throughout the pregnancy (unless advised otherwise by your doctor for medical reasons), do moderate exercise and continue normal activities as much as possible.
- Stay relaxed and calm — practise breathing exercises, relaxation techniques and meditation; listen to music and focus on self-care. Controlled breathing can also give relief from pain during labour.
- Eat a balanced diet that is high in fibre and protein. Avoid foods that are loaded with sugar and saturated fats.
- Ensure you ask for help when you need it. Fathers-to-be can take the responsibility to make expectant mothers feel relaxed during the birthing process.
“Regular walking, a nutritious diet and doing light stretching and pelvic exercises to strengthen the muscles help position the baby properly in the womb and allow the mother to cope better with labour pain and to push the baby out. There are many options available — both medical and non-medical – for labour pain relief. It is for the woman to decide what type of pain management during labour, she wants to adopt,” says Sura Pushpalatha, consultant, obstetrics and gynecology, Gleneagles Global Health City, Chennai.
What is labour pain?
Labour pain occurs in a pregnant woman when the uterine muscles contract and relax, preparing to push the baby out of the womb. Labour pains occur in the form of cramps in the abdomen and pelvic region, backache and pain around the thighs.
A 2012-study ‘Pain management in labour for women: an overview’ by Jones L et al. published in the Cochrane Database of Systematic Reviews found that non-drug methods such as immersion in water, relaxation, acupuncture and massage gave mothers good relief from pain during labour and childbirth and that some of these options may reduce forceps delivery and Cesarean section births.
The study also pointed out that medical interventions including inhaled nitrous oxide, sedatives, epidurals, local anesthetics and injected drugs are more effective in relieving labour pain but may pose the risk of nausea, low blood pressure, fever, giddiness and restricted leg movement. Epidurals may lead to forceps use and an increased number of C-sections.
Non-medical options available for coping with labour pain
Mobility and different positions
Studies have shown that staying active when your contractions start helps you manage pain better. Move around the room or sway a little when you have contractions. Try different positions to get relief such as sitting on an exercise/birthing ball with your knees bent; lying on your side with a pillow between your legs; leaning forward while standing, squatting and so on.
Massage, acupressure and heat packs
A gentle massage given to the back, arms and thighs by your partner can lessen the pain from contractions and help relax the muscles. Hot packs help relieve pain; applying heat also releases endorphins in the body – this is a natural way of getting pain relief. Acupressure is known to give relief from pain and discomfort during labour but should be administered by a professional therapist trained in acupressure technique.
Water immersion
“Water births are a good way of having a smooth and relaxed childbirth, as long as your doctor gives the green signal for the same. But very few hospitals and birthing centres (in India) have this facility. Instead, I usually advise taking a warm shower or immersing in a clean tub filled with warm water in the early stages of labour, as it gives immense relief to the mother-to-be and also helps her feel less anxious. It is also important for the mother to stay hydrated; she can take small sips of fluids during the labour and childbirth process,” says Dr Asha Baxi, consultant obstetrician, gynecologist and infertility specialist, Motherhood Hospitals, Indore.
Transcutaneous electrical nerve stimulation (TENS) machine
This is a device used to pass tiny electric currents to the pregnant woman’s body through electrodes that are attached to her back. This device is safe and gives moderate and temporary relief from pain during labour.
Hypnobirthing
This birthing technique uses hypnosis so that the mother feels relaxed and gets help in pain management but not many hospitals may have facilities or give permission for this method. It is also important to ensure that a qualified hypnotherapist, who has experience with births, is available to assist the mother in the process.
Medical options for pain relief
Nitrous Oxide
This is one of the oldest methods of pain relief and is still used in some hospitals. Nitrous oxide gas is mixed with oxygen (this is called Entonox) and the pregnant woman inhales it through a mask when she gets the contractions. Pain relief is temporary in this method.
Epidural block
According to the American College of Obstetricians and Gynecologists, an epidural block is a medication administered using a catheter inserted into the epidural space in the lower back of the pregnant woman.
It could be a combination of analgesics and anesthetic medicine that results in a loss of feeling in the lower part of the body.
“The good thing about an epidural is that the mother is awake and able to enjoy the birth of her child without the pain and exhaustion of labour. In case there is a need for a C-section, we can increase the dosage of the epidural and continue with the procedure,” says Dr Baxi.
Opioids
These are medications administered to the pregnant woman through an intravenous line and help her get relief from pain for a few hours. But the side-effect of this medication is that it causes drowsiness and can slow down the baby’s heart rate.
Pudendal block
This is a medication given in the form of an injection that blocks pain in the area between the vagina and the anus.
We encourage you to discuss the options with your gynecologist and choose the one best suited to you. Happy motherhood!
