"Through a series of role-plays, we learned that if we requested an epidural (which involves inserting a big needle into your spine) to numb the pain, we'd end up flat on our backs, strapped up to an array of monitors and machines that go beep. Not only would this quash any hopes of a beautiful water-birth, we'd be more likely to need a c-section or a birth involving forceps which might make us tear. This was terrifying. Not only am I afraid of needles, I was terrified of tearing, and our teacher had also told us that a c-section would make breastfeeding difficult; would make it hard to bond with our babies; and would take weeks to recover from.
The overriding impression I was left with was that birth is something women can control, that doctors aren't to be trusted, and that if I did end up requesting an epidural or needing a c-section I would have failed in some way."Read more about what to expect about labour pain here...
What does it mean? Self-help means that you don't take any form of pain relief during labour and work your way towards the birth of your baby with your own will power and strength.
What is used? You can use relaxation and breathing techniques to tide over the phase. Being mobile helps, so it is best to adopt the most comfortable and useful positions. Having someone with you can be a real source of encouragement so try not to go for it all on your own.
What else? If your intention is to bear the labour pains naturally and not use any form of pain relief, still keep your options open. Labour pains can be extremely painful.
How does it work? This is a mixture of oxygen(50%) and nitrous oxide(50%) which is breathed in through a mask connected to a cylinder through a tube. You hold the mask and are in the control of the mixture being inhaled. It is useful in the first stage of labour.
Effectiveness: It takes about 20 seconds to take effect so you need to inhale the mixture just at the beginning of the contraction. It doesn't take away the pain completely but helps make it bearable. The effect of the inhalation last for a few seconds only so the mixture has to be inhaled consistently throughout.
* Easy to use
* You are in control of the mixture you are inhaling
* You are free to move about
Side effects in you:
* Makes you feel light-headed and sleepy
* Inhaling the mixture may make you feel sick
Side effects in the baby:
None (as the gas is processed in your lungs)
How do they work? There is a choice of pethidine and meptid. Meptid is not as strong as pethidine and is given to mothers who have had more than one baby. Pethidine continues to be used commonly. It is a pain relieving drug. An intramuscular injection is administered either in the buttocks or the thigh. It takes about 20 minutes to take effect which lasts for upto two to three hours.
Effectiveness: It is a fairly good method of pain relief as it relaxes you and lessens the pain. It is best given in the first stage of labour. An internal examination may be carried out before injecting you to ensure that you are not about to deliver.
* Lessens the pain
* Helps to relax you
Side effects in you:
* Some women feel light-headed, out of control and 'drunk' while others feel calm and relaxed.
* It may cause nausea and you may need an anti-sickness injection as well.
* Pushing can be difficult if the effect of pethidine hasn't worn off by the time you begin to push.
Side effects in the baby:
* If given too late in labour, pethidine can cause slow breathing in your newborn and also make him very sleepy.
* However, neither is a major concern as slow breathing can be corrected by supplying oxygen and sleepiness tends to wear off.
How does it work? It is a local anaesthetic that is injected into the space between your spinal column and spinal cord. This numbs the nerves to the lower part of the body (stomach, back passage, vagina) including the legs. As a result, you don't feel any pain in that part of your body.
How is it administered?
* The entire process takes about 20 minutes.
* The epidural is administered by an anaesthetist.
* You will be asked to lie very still on your side with your knees tucked under your chin to round the back. Alternatively you may be asked to sit up. If you feel a contraction during the process, you must inform the anaesthetist so that he can stop and wait for the contraction to pass.
* The anaesthetic will be injected through a small tube in your lower back, in the space between the spinal cord and the spinal column.
* The tube is left in place so that further top-ups can be given, if required.
* A drip will be set up in your arm and you and your baby will be monitored (a foetal monitoring belt may be placed around your abdomen for this purpose).
* It will take about 15 minutes for the anaesthetic to take effect.
Effectiveness: It is a complete form of pain relief as you will feel no pain in your lower half. The anaesthetic wears off in 2-3 hours and further top-ups may be required.
* Blocks the pain completely.
* If you go on to have a Caesarean, the epidural can be topped up and you will be fully awake throughout the operation.
* You don't feel so tired after the delivery.
* It can be very useful in extremely painful labour especially back labour.
Side effects in you:
* As the legs become numb and heavy, you may feel very awkward and uncomfortable.
* You will be confined to the bed once the epidural is administered. (However, some hospitals offer epidurals that allow you to be mobile)
* As all sensations in the lower part of body are numbed, you will not be able to pass water. A small catheter will be used to empty the bladder.
* You will not be able to get out of bed several hours after delivery.
* Some women complain of backache for sometime after having an epidural.
* In very few cases, a severe but treatable headache may occur.
Side effects in the baby: None. However, your chances of having an episiotomy and forceps delivery are increased with an epidural. This is because you are not able to push completely because of lack of sensation in that part of the body and a little assistance may be required in delivering your baby.
Remember! All hospitals don't offer epidurals. If yours does, find out about the availability of anaesthetists.
What are they? Alternative methods of pain relief include aromatherapy, reflexology, homeopathy, hypnosis and massage.
When are they used? You may want to use these combined with any other form of pain relief or you may use just these alternative methods and no regular pain relief method at all.
Remember! If you're planning to use any of the alternative methods of pain relief, you must inform the hospital in advance.